JP2014511223A5 - - Google Patents

Description

Devices and methods for treating vascular and body conduits

  This application claims priority from US patent application Ser. No. 13 / 303,890, filed Nov. 23, 2011, and is a continuation-in-part of that application. This is a continuation-in-part of U.S. Patent Application No. 13 / 021,364, filed February 4, 2010, which is a continuation-in-part of U.S. Patent Application No. 12 / filed on Jul. 8, 2010. No. 832,857, which is a continuation-in-part of U.S. patent application Ser. No. 12 / 643,942, filed on Dec. 21, 2009, part of which is a continuation-in-part application. The continuation application is a continuation-in-part of U.S. Patent Application No. 12 / 573,676, filed on October 5, 2009, and the continuation application is a U.S. application filed on July 8, 2009. One of patent application No. 12 / 499,713 It is a continuation application.

  This application relates to devices and methods for treating vasculature and other ducts in the body.

  Self-expanding prostheses (such as the ability to expand themselves without external force), such as stents, covered stents, vascular grafts, flow diverters, etc. Has been developed to treat ducts in the body. Many of these prostheses have been developed to treat intravascular obstructions (blockages, emboli, thrombus) and aneurysms that occur in the brain. What is needed is an improved method and device for treatment of vessels and other body conduits, such as aneurysms, stenoses, embolic obstructions, and the like.

According to one embodiment, a device for treating a vessel or body conduit is provided,
The device has a longitudinal self-expandable member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but is expanded radially in the second indwelling position. In a radially expanded state and having a second nominal (nominal, average) diameter,
Its second nominal diameter is greater than the first nominal diameter for deployment within the body conduit or vessel of the patient,
The self-expanding member has a plurality of cell structures,
The self-expanding member includes a proximal end portion having a proximal end, a cylindrical body portion, and a distal portion. distal, far from the surgeon) with a distal end having an end,
The plurality of cell structures located in the main body extend circumferentially around the long axis of the self-expanding member, while the proximal end and the far end The plurality of cell structures located at the distal ends extend around the major axis of the self-expanding member partially (less than circumferentially, partially) rather than over the entire circumference,
The cell structure located on the outermost side at the proximal end has a proximal straight wall segment that is a plurality of straight wall segments that are straightest and located closest to the proximal end. ,
The nearest straight wall segments form first and second, substantially straight linear rail segments when viewed in a two-dimensional plan view,
The straight rail segments are each located on or near the proximal end of the self-expanding member from a distal position on the tubular body or the It extends to a distal position proximate to the body portion.
In one embodiment, the self-expanding member has a length extending along at least a portion of the total length of the self-expanding member and located between the proximal end and the distal end. Shaped slit.

According to another embodiment, a kit is provided,
The kit has a longitudinal flexible wire that has a proximal end and a distal end;
A longitudinal self-expanding member is connected to its distal end,
The self-expanding member is capable of moving from a first feeding position to a second indwelling position;
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment in a patient's body conduit or vessel,
The self-expanding member has a plurality of cell structures,
The self-expanding member has a proximal end having a proximal end, a tubular main body, and a distal end having a distal end,
The plurality of cell structures located in the main body portion extend around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures located in the proximal end portion and the distal end portion include Extends around the long axis of the self-expanding member partially rather than over the entire circumference,
The outermost cell structure located at the proximal end has a proximal straight wall segment that is a plurality of straight wall segments that are rectilinear and that are most proximal.
The nearest straight wall segments form a plurality of straight rail segments that are first and second, substantially straight when viewed in a two-dimensional plan view,
The straight rail segments are each located on or near the proximal end of the self-expanding member from a distal position on the tubular body or the Extends to a distal position close to the body,
The elongated wire and the self-expanding member have a first length dimension in a state of being connected to each other,
The kit further comprises a delivery catheter,
The delivery catheter has a second length dimension and is flexible enough to be navigated within the vessel or body conduit of the patient;
The delivery catheter has a proximal end, a distal end, and a lumen;
The lumen has a diameter sufficient to accommodate the self-expanding member in the non-expanded state, and the self-expanding member in the non-expanded state from the proximal end of the delivery catheter Having one that can be moved to the distal end,
The second length dimension is shorter than the first length dimension so that the self-expanding member is distal to the distal end of the delivery catheter beyond the distal end. In the direction of approaching the treatment site), whereby the self-expanding member is deployed to be in the expanded state,
The distal end of the delivery catheter and the self-expanding member are such that when the self-expanding member is partially or fully deployed outside the distal end of the delivery catheter, It is configured to proceed in a proximal direction (proximal direction) and allow it to be stored in the lumen of the delivery catheter.
In one embodiment, the self-expanding member has a length extending along at least a portion of the total length of the self-expanding member and located between the proximal end and the distal end. Shaped slit.

According to one embodiment, a device for treating a body conduit or vessel is provided,
The device has a longitudinal self-expanding member that is movable from a first delivery position to a second indwelling position;
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
The second nominal diameter is greater than the first nominal diameter for deployment within the body conduit or vessel of the patient;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other (diagonally disposed). Having connected to each other so as to form a cell structure,
The self-expanding member has a proximal end, a tubular main body, and a distal end.
The plurality of cell structures located in the main body portion extend around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures located in the proximal end portion and the distal end portion include Extends around the long axis of the self-expanding member partially rather than over the entire circumference,
The outermost cell structure located at the proximal end has a proximal straight wall segment that is a plurality of straight wall segments that are rectilinear and that are most proximal.
The nearest straight wall segments form a plurality of straight rail segments that are first and second, substantially straight when viewed in a two-dimensional plan view,
The straight rail segments are each located on or near the proximal end of the self-expanding member from a distal position on the tubular body or the It extends to a position close to the main body.
In one embodiment, a longitudinal flexible wire extending in the proximal direction is connected to the most proximal end of the self-expanding member, and the wire is connected to the vessel or the body of the patient. It has sufficient length and flexibility to be guided through the conduits and to access (reach) those vessels or body conduits.

According to another embodiment, a device for treating a vessel is provided,
The device has a longitudinal self-expanding member;
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment within the patient's vasculature,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the long axis direction, and among the wavy elements adjacent to each other, the self-expanding member moves toward the expanded state from the non-expanded state. In a state of being connected to each other so as to form a plurality of cell structures arranged to induce twisting of the expansion member,
The self-expanding member has a proximal end, a tubular main body, and a distal end.
The plurality of cell structures located in the main body portion extend around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures located in the proximal end portion and the distal end portion include Extends around the long axis of the self-expanding member partially rather than over the entire circumference,
The outermost cell structure located at the proximal end has a proximal straight wall segment that is a plurality of straight wall segments that are rectilinear and that are most proximal.
The nearest straight wall segments form a plurality of straight rail segments that are first and second, substantially straight when viewed in a two-dimensional plan view,
Each of the linear rail segments extends from a position on or near the proximal end of the self-expanding member to a distal position on the tubular body or to the body. It extends to a close position.
In one embodiment, a longitudinal flexible wire extending in the proximal direction is connected to the most proximal end of the self-expanding member, and the wire is connected to the vessel or the body of the patient. It has sufficient length and flexibility to be guided through the conduit and to access those vessels or body conduits.

According to another embodiment, a device for treating a body conduit or vessel is provided,
The device has a longitudinal self-expanding member;
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
The second nominal diameter is greater than the first nominal diameter for deployment within the body conduit or vessel of the patient;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a tubular portion and a distal end;
The plurality of cell structures positioned in the tubular portion extend around the entire circumference of the long axis of the self-expanding member, while the plurality of cell structures positioned at the distal end portion are the length of the self-expanding member. Extends around the axis partly, not over the entire circumference,
The cell structure located on the outermost side has a plurality of end points located closest to the proximal end in the cylindrical portion.
One or more of the most proximal end points of the self-expanding member have a longitudinal flexible wire extending in the proximal direction;
The wire is sufficiently long and flexible to be guided through and reach the vessel or body conduit of the patient.

According to another embodiment, a kit is provided,
The kit has a longitudinal flexible wire that has a proximal end and a distal end;
A longitudinal self-expanding member is connected to its distal end,
The self-expanding member is capable of moving from a first feeding position to a second indwelling position;
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment in a patient's body conduit or vessel,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end having a proximal end, a tubular main body, and a distal end having a distal end,
The plurality of cell structures located in the main body portion extend around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures located in the proximal end portion and the distal end portion include Extends around the long axis of the self-expanding member partially rather than over the entire circumference,
The outermost cell structure located at the proximal end has a proximal straight wall segment that is a plurality of straight wall segments that are rectilinear and that are most proximal.
The nearest straight wall segments form a plurality of straight rail segments that are first and second, substantially straight when viewed in a two-dimensional plan view,
The straight rail segments are each located on or near the proximal end of the self-expanding member from a distal position on the tubular body or the Extends to a distal position close to the body,
The elongated wire and the self-expanding member have a first length dimension in a state of being connected to each other,
The kit further comprises a delivery catheter,
The delivery catheter has a second length dimension and is flexible enough to be guided in the vessel or body conduit of the patient;
The delivery catheter has a proximal end, a distal end, and a lumen;
The lumen has a diameter sufficient to accommodate the self-expanding member in the non-expanded state, and the self-expanding member in the non-expanded state from the proximal end of the delivery catheter Having one that can be moved to the distal end,
The second length dimension is shorter than the first length dimension, thereby allowing the self-expanding member to move distally beyond the distal end of the delivery catheter, thereby The self-expanding member is deployed to be in the expanded state,
The distal end of the delivery catheter and the self-expanding member are such that when the self-expanding member is partially or fully deployed outside the distal end of the delivery catheter, It is configured to proceed in a proximal direction and allow it to be stored within the lumen of the delivery catheter.

According to another embodiment, a method is provided for removing embolic obstruction from a patient's lumen (vessel),
The method is
(A) advancing the delivery catheter, which is closer to the site where the embolus is present in the patient's intracranial vasculature (intracranial vasculature) A lumen having a distal end and a distal end, whereby the distal end of the lumen is located distal to the embolus, the lumen having a first length dimension. What you have,
(B) introducing a retrieval device into the proximal end of the lumen of the delivery catheter and introducing a longitudinal self-expanding member into the lumen; Advancing to the distal end, wherein the embolus retrieval device has a longitudinal flexible wire, the wire having a proximal end and a distal end; The self-expanding member is coupled to the self-expanding member, and the self-expanding member is movable from the first feeding position to the second indwelling position. The self-expanding member is at the first feeding position. In a non-expanded state and having a first nominal diameter but in the second indwelling position it is in a radially expanded radially expanded state and has a second nominal diameter; 2 Nominal diameter is the patient's body conduit Or for deployment within the vessel, the self-expanding member is larger than the first nominal diameter, and each of the self-expanding members includes a plurality of generally wavy elements, each of which is adjacent to each other. Proximal ends having a proximal end, wherein the self-expanding members are connected to each other to form a plurality of cell structures diagonally arranged diagonally to each other. And a plurality of cell structures located on the main body portion extend around the major axis of the self-expanding member over the entire circumference. On the other hand, the plurality of cell structures located at the proximal end and the distal end partially extend around the long axis of the self-expanding member over the entire circumference, and at the proximal end The outermost cell structure is the most A plurality of straight wall segments that are straight, nearest straight wall segments, and the nearest straight wall segments are first and second when viewed in a two-dimensional plan view. A plurality of substantially linear rail segments, each of which is on or on the most proximal end of the self-expanding member. The longitudinal wire and the self-expanding member are connected to each other, extending from a close position to a distal position on the cylindrical body portion or a distal position close to the body portion. Having a second length dimension longer than the first length dimension in a state;
(C) the delivery catheter is sufficient for the self-expanding member to be deployed such that at least one of the plurality of cell structures entraps at least a portion of the embolus; Retracting proximally to
(D) retracting the delivery catheter and the self-expanding member proximally and withdrawing out of the patient's body.
In another embodiment, the self-expanding member is partially or fully prior to the delivery catheter and the self-expanding member being retracted proximally and retracted out of the patient's body. Retracted within the lumen of the delivery catheter.

According to another embodiment, a device is provided,
The device has a longitudinal self-expanding member;
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment within a patient's vessel or conduit,
The self-expanding member has a plurality of cell structures,
The self-expanding member has a proximal end portion having a proximal end and a cylindrical main body portion;
The plurality of cell structures located in the main body have a plurality of first intersecting struts connected to intersect with each other, and extend around the major axis of the self-expanding member over the entire circumference. The plurality of cell structures located at the distal ends have a plurality of second intersecting struts that are connected to intersect with each other, and partially extend around the major axis of the self-expanding member over the entire circumference. And
The ratio of the thickness dimension (radial dimension) of at least a part of the plurality of first intersecting struts to the width dimension (circumferential dimension) is greater than one.

According to yet another embodiment, a device is provided,
The device has a feed wire and a longitudinal self-expanding member;
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment within a patient's vessel or conduit,
The self-expanding member has a plurality of cell structures,
The self-expanding member has a proximal end having a proximal end and a cylindrical main body, and the proximal end is integrally formed with the proximal end so as to extend from the proximal end. Having a formed wire segment;
A coil is placed around the wire segment,
The coil has a first closely wound segment and a second loosely wound segment having at least one gap;
The plurality of cell structures located in the main body portion extend around the entire circumference of the long axis of the self-expanding member, while the plurality of cell structures located in the proximal end portion are long axes of the self-expanding member. It extends partially, not around the entire circumference,
The proximal end of the wire segment is connected to the distal end of the delivery wire using a bonding agent in the gap of the second loosely wound segment of the coil.

According to yet another embodiment, a device is provided,
The device has a feed wire and a longitudinal self-expanding member;
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment within a patient's vessel or conduit,
The self-expanding member has a plurality of cell structures,
The self-expanding member has a proximal end portion having a proximal end and a cylindrical main body portion;
The plurality of cell structures located in the main body portion extend around the entire circumference of the long axis of the self-expanding member, while the plurality of cell structures located in the proximal end portion are long axes of the self-expanding member. It extends partially, not around the entire circumference,
The plurality of cell structures are such that the self-expanding member is radially oriented within an initial diameter expansion range in which the self-expanding member initially expands about 0.5 mm radially from the first nominal diameter (unexpanded state). The total value over the entire length of the self-expanding member in an amount that reduces the radial force acting on the self-expanding member is assumed to be about −1.5 N to about −3.5 N. And within the diameter range subsequent to the initial diameter expansion range, assuming that the self-expanding member expands by 1 mm in the radial direction, the radial force acting on the self-expanding member is The decreasing amount of the total value of the self-expanding member over the entire length has dimensional and material properties that range from about -0.10 N to about -0.50 N.
In one embodiment, the elongate self-expanding member has a maximum design value of the second nominal diameter, and the radius acting on the self-expanding member when the self-expanding member expands to the maximum design value. Directional force is greater than zero.

According to yet another embodiment, a device is provided,
The device has a feed wire and a longitudinal self-expanding member;
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is greater than said first nominal diameter for deployment within a patient's vessel or conduit,
The self-expanding member has a plurality of cell structures,
The self-expanding member has a proximal end, a tubular main body, and a distal end.
The plurality of cell structures located in the main body portion extend around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures located in the proximal end portion and the distal end portion include Extends around the long axis of the self-expanding member partially rather than over the entire circumference,
The self-expanding member expands by 1 mm in the radial direction within an initial diameter expansion range in which the plurality of cell structures initially expand by about 0.5 mm in the radial direction from the first nominal diameter (unexpanded state). , The total value over the entire length of the self-expanding member in an amount that reduces the radial force acting on the self-expanding member is in the range of about -1.5N to about -3.5N. In addition, in a diameter range subsequent to the initial diameter expansion range, when it is assumed that the self-expanding member expands by 1 mm in the radial direction, the amount of the radial force acting on the self-expanding member is reduced. The total value over the entire length of the self-expanding member has dimensional and material properties that range from about -0.10 N to about -0.50 N.
In one embodiment, the elongate self-expanding member has a maximum design value of the second nominal diameter, and the radius acting on the self-expanding member when the self-expanding member expands to the maximum design value. Directional force is greater than zero.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from a first delivery position to a second placement position;
The self-expanding member is in an unexpanded position in the first delivery position and has a first nominal diameter, but is radially in the second indwelling position. In a radially expanded position and having a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of undulating elements extending in a major axis direction diagonally so that adjacent ones of the undulating elements are diagonally aligned with each other (diagonally) disposed), in a state of being connected to each other so as to form a plurality of cell structures,
The self-expanding member has a proximal end portion and a cylindrical body portion;
Among the plurality of cell structures, the one located in the main body portion extends circumferentially around the major axis of the self-expanding member, while the proximal end portion of the plurality of cell structures. Located in the self-expanding member is less than longitudinally around the major axis of the self-expanding member, thereby providing a first peripheral rail and a second peripheral rail, Forming one having a proximal end segment and a distal end segment;
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have the most proximal cell structure (proximal-most cell structure) common to both,
Among the plurality of cell structures, one located in the main body includes a fourth cell structure set including a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A plurality of strut members that are outer-most strut members that define the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members each have different width dimensions, and the first peripheral rail and the second peripheral rail are the proximal end segment. From the first width dimension at the first end to the second width dimension at the distal end segment so as to vary along the length;
The second width dimension is smaller than the first width dimension.
In one embodiment, the first peripheral rail and the second peripheral rail do not have undulations, and the percentage change between the first width dimension and the second width dimension. The percentage (percentage change) is between about 20.0% and about 50.0%.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end portion and a cylindrical body portion,
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. One extends partly around the major axis of the self-expanding member rather than over its entire circumference, whereby a first peripheral rail and a second peripheral rail comprising a proximal end segment and a distal end segment Forming what has
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, one located in the main body includes a fourth cell structure set including a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension;
A percentage change between the first width dimension and the second width dimension is between about 20.0% and about 50.0%;
The third cell structure set includes a plurality of struts having a third width dimension smaller than the second width dimension;
The fourth cell structure set includes a plurality of struts having a fourth width dimension smaller than the second width dimension;
The percentage change between the second width dimension and the third width dimension is a percentage change between about 10.0% and about 25.0%. Yes,
The percentage change between the second width dimension and the fourth width dimension is a percentage change between about 10.0% and about 25.0%. is there.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end portion and a cylindrical body portion,
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. One extends partly around the major axis of the self-expanding member rather than over its entire circumference, whereby a first peripheral rail and a second peripheral rail comprising a proximal end segment and a distal end segment Forming what has
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, one located in the main body includes a fourth cell structure set including a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension;
A percentage change between the first width dimension and the second width dimension is between about 20.0% and about 50.0%;
The third cell structure set includes a plurality of struts having a third width dimension smaller than the second width dimension;
The fourth cell structure set includes a plurality of struts having a fourth width dimension substantially equal to the second width dimension;
The percentage change between the second width dimension and the third width dimension is a percentage change between about 10.0% and about 25.0%. is there.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end portion and a cylindrical body portion,
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. One extends partly around the major axis of the self-expanding member rather than over its entire circumference, whereby a first peripheral rail and a second peripheral rail comprising a proximal end segment and a distal end segment Forming what has
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, those located in the main body include a fourth cell structure set composed of a plurality of cell structures and a fifth cell structure set composed of a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension;
Of the plurality of cell structures, the size of the one located in the third cell structure set and the size of the plurality of cell structures located in the fifth cell structure set are substantially equal to each other. Equal to
Of the plurality of cell structures, the size of the one located in the fourth cell structure set is larger than the size of the plurality of cell structures located in the third cell structure set,
Among the plurality of cell structures, those located in the third cell structure set, the fourth cell structure set, and the fifth cell structure set are the third strut, the fourth strut, and the fifth strut, respectively. Including struts,
At least some of the fourth and fifth struts or segments thereof have a width dimension that is greater than the width dimension of the third strut (the plurality of third struts).

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end portion and a cylindrical body portion,
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. One extends partly around the major axis of the self-expanding member rather than over its entire circumference, whereby a first peripheral rail and a second peripheral rail comprising a proximal end segment and a distal end segment Forming what has
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, those located in the main body include a fourth cell structure set composed of a plurality of cell structures and a fifth cell structure set composed of a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension;
Of the plurality of cell structures, the size of the one located in the third cell structure set and the size of the plurality of cell structures located in the fifth cell structure set are substantially equal to each other. Equal to
Of the plurality of cell structures, the size of the one located in the fourth cell structure set is larger than the size of the plurality of cell structures located in the third cell structure set,
Among the plurality of cell structures, those located in the third cell structure set, the fourth cell structure set, and the fifth cell structure set are the third strut, the fourth strut, and the fifth strut, respectively. Including struts,
The width dimension of the third strut is smaller than the second width dimension,
At least a part of the fourth slat and the fifth strut or a segment thereof has a width dimension substantially equal to the second width dimension.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end, a tubular body, and a distal end;
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. One extends partly around the major axis of the self-expanding member rather than over its entire circumference, whereby a first peripheral rail and a second peripheral rail comprising a proximal end segment and a distal end segment Forming what has
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, one located in the main body includes a fourth cell structure set including a plurality of cell structures,
Among the plurality of cell structures, the one located at the distal end includes a sixth cell structure set including a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension.
In one embodiment, the first peripheral rail and the second peripheral rail do not have undulations, and the percentage change between the first width dimension and the second width dimension. The percentage (percentage change) is between about 20.0% and about 50.0%.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end, a tubular body, and a distal end;
Among the plurality of cell structures, the one located in the main body extends around the long axis of the self-expanding member over the entire circumference, while the proximal end portion and the far end of the plurality of cell structures are included. Located at the distal end extends partially rather than around the long axis of the self-expanding member, thereby providing a first peripheral rail and a second peripheral rail, the proximal end Forming a segment and a distal end segment;
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, those located in the main body include a fourth cell structure set composed of a plurality of cell structures and a fifth cell structure set composed of a plurality of cell structures,
Among the plurality of cell structures, the one located at the distal end includes a sixth cell structure set including a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension;
Of the plurality of cell structures, the size of the one located in the third cell structure set, the size of the plurality of cell structures located in the fifth cell structure set, and the plurality of cells Of the structures, the sizes of those located in the sixth cell structure set are substantially equal to each other,
Among the plurality of cell structures, the size of the cell structure located in the fourth cell structure set is the third cell structure set, the fifth cell structure set, and the first of the plurality of cell structures. Larger than the size of the one located in the 6-cell structure set,
Among the plurality of cell structures, those located in the third cell structure set, the fourth cell structure set, the fifth cell structure set, and the sixth cell structure set are respectively third Including struts, fourth struts, fifth struts and sixth struts,
At least a part of the fourth slat and the fifth strut or a segment thereof has a width dimension larger than a width dimension of the third strut and the sixth strut.

According to another embodiment, a clot retrieval device is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal end, a tubular body, and a distal end;
Among the plurality of cell structures, the one located in the main body extends around the long axis of the self-expanding member over the entire circumference, while the proximal end portion and the far end of the plurality of cell structures are included. Located at the distal end extends partially rather than around the long axis of the self-expanding member, thereby providing a first peripheral rail and a second peripheral rail, the proximal end Forming a segment and a distal end segment;
Among the plurality of cell structures, the one located at the proximal end includes a first cell structure set including a plurality of cell structures arranged to form the first peripheral rail; A second cell structure set comprising a plurality of cell structures arranged to form a two peripheral rail, and a plurality of cell structures located between the first peripheral rail and the second peripheral rail A third cell structure set;
The first cell structure set and the second cell structure set have a most proximal cell structure positioned closest to the proximal end as a common to both.
Among the plurality of cell structures, those located in the main body include a fourth cell structure set composed of a plurality of cell structures and a fifth cell structure set composed of a plurality of cell structures,
Among the plurality of cell structures, the one located at the distal end includes a sixth cell structure set including a plurality of cell structures,
The nearest cell structure and the first cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the first peripheral rail;
The nearest cell structure and the second cell structure set each have a cylindrical shape (circumferential, extending in the circumferential direction) and are located on the outermost side (outer-most, located on the outermost side in the length direction). A) a circumferential outermost strut member that is a plurality of strut members and that defines the second peripheral rail;
At least some of the plurality of circumferential outermost strut members have width dimensions different from each other, and the first peripheral rail and the second peripheral rail are separated from the first width dimension in the proximal end segment. , Arranged to vary along the length up to a second width dimension at the distal end segment;
The second width dimension is smaller than the first width dimension;
Of the plurality of cell structures, the size of the one located in the third cell structure set, the size of the plurality of cell structures located in the fifth cell structure set, and the plurality of cells Of the structures, the sizes of those located in the sixth cell structure set are substantially equal to each other,
Among the plurality of cell structures, the size of the cell structure located in the fourth cell structure set is the third cell structure set, the fifth cell structure set, and the first of the plurality of cell structures. Larger than the size of the one located in the 6-cell structure set,
Among the plurality of cell structures, those located in the third cell structure set, the fourth cell structure set, the fifth cell structure set, and the sixth cell structure set are respectively third Including struts, fourth struts, fifth struts and sixth struts,
At least a part of the fourth slat and the fifth strut or a segment thereof has a width dimension substantially equal to the second width dimension.

According to some other embodiments, an embolic recovery device for recovering embolic obstruction is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. Is partially extending around the long axis of the self-expanding member rather than over the entire circumference,
Among the plurality of cell structures, the outermost cell structure, which is a plurality of cell structures located on the outermost side among those located at the proximal end, has a plurality of nearest positions located on the most proximal side. Has a wall segment,
These nearest wall segments form a first rail segment and a second rail segment;
The first rail segment and the second rail segment are respectively the same as the most proximal end located closest to the proximal end of the self-expanding member or the vicinity thereof, and the cylindrical main body portion. Extend to the same position or a position near it,
Among the plurality of cell structures, the nearest cell structure, which is a plurality of cell structures positioned closest to the proximal end of the plurality of cell structures, includes a first outer strut and a second outer strut. Including
The first outer strut and the second outer strut are distally from the proximal antenna and in a two-dimensional deployed state, at least a portion of each of the first outer strut and the second outer strut is Extends to include straight segments,
Each straight segment of the first outer strut and the second outer strut can extend together (coextensive in parallel) to the proximal antenna.

According to some other embodiments, an embolic recovery device for recovering embolic obstruction is provided,
The thrombectomy device has a longitudinal self-expanding member,
The self-expanding member can move from the first feeding position to the second indwelling position,
The self-expanding member is in an unexpanded state in the first delivery position and has a first nominal diameter, but in a radially expanded state in the second indwelling position. And has a second nominal diameter,
Its second nominal diameter is larger than said first nominal diameter for deployment within a patient's embolic obstruction,
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. In a state of being connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
Among the plurality of cell structures, the one located in the main body portion extends around the long axis of the self-expanding member over the entire circumference, and is located at the proximal end portion of the plurality of cell structures. Is partially extending around the long axis of the self-expanding member rather than over the entire circumference,
Among the plurality of cell structures, the first cell structure set consisting of a plurality of outermost cell structures located on the outermost side among the ones located at the proximal end is respectively closest to the most proximal side. Has a plurality of closest wall segments located,
These nearest wall segments form a non-wavy rail segment,
The non-corrugated rail segment is located at the same position as the proximal end located closest to the proximal end of the self-expanding member or a position near it, and the same position as the cylindrical main body or a position near it. Extended,
Among the plurality of cell structures, the second cell structure set including a plurality of outermost cell structures located on the outermost side among the ones located at the proximal end portion is arranged closest to the proximal end. Has a plurality of closest wall segments located,
These nearest wall segments form a wavy rail segment,
The wavy rail segment extends from the same position as the proximal end located closest to the proximal end of the self-expanding member or a position close thereto to the same position as the cylindrical main body or a position adjacent thereto. ing.

According to some other embodiments, an embolic recovery device for recovering embolic obstruction is provided,
The embolus retrieval device includes a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
In the radially expanded state, the distal section of the tubular body has an average diameter that is greater than the average diameter of the proximal section of the tubular body.
In some embodiments, of the plurality of cell structures, the one existing in the distal section of the cylindrical body portion includes the cell body of the plurality of cell structures. Having an average diameter greater than the average diameter of those present in the proximal section;
Of the plurality of cell structures, those present in the proximal section of the tubular body portion have an average diameter greater than the average diameter of the plurality of cell structures present in the proximal end. Have
Among the plurality of cell structures, an average length / width ratio, which is a ratio of a length dimension to a width dimension, of the proximal end portion and the cylindrical body portion is determined by the self-expanding member in the restrained state. And greater than 1 when in the unconstrained state.

According to some other embodiments, an embolic recovery device for recovering an embolus is provided,
The embolus retrieval device includes a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the distal section of the cylindrical body portion are present in the plurality of cell structures within the proximal section of the cylindrical body portion. Having an average length / width ratio greater than the average length / width ratio, which is the ratio of the length dimension to the width dimension;
Of the plurality of cell structures, those present in the proximal section of the tubular body portion are widths of the length dimension of the plurality of cell structures present in the proximal end. Having an average length / width ratio that is greater than an average length / width ratio that is a ratio to the dimensions;
The average length / width, which is the ratio of the length dimension of the plurality of cell structures present in the proximal end to the width dimension, is determined when the self-expanding member is in the radially expanded state and the radius. Greater than 1 when in unexpanded state.

According to some other embodiments, an embolic recovery device for recovering an embolus is provided,
The embolus retrieval device includes an elongate (having a long axis) self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the cylindrical main body portion are proximally facing (proximal facing, facing the proximal end of the self-expanding member), and a proximal V-shaped structure; A distal V-shaped structure facing away (facing the distal end of the self-expanding member);
The proximal V-shaped structure and the distal V-shaped structure extend diagonally (diagonally extending, obliquely with respect to the long axis of the self-expanding member) and are spaced apart from each other in the circumferential direction. Are connected to each other by a pair of diagonally and circumferentially spaced struts,
The proximal V-shaped structure and the distal V-shaped structure have a first average width dimension;
The pair of diagonally and circumferentially spaced struts has a second average width dimension that is larger than the first average width dimension.

According to some other embodiments, an embolic recovery device for recovering an embolus is provided,
The embolus retrieval device includes a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the cylindrical main body include a proximal V-shaped structure facing the proximal direction and a distal V-shaped structure facing the distal direction,
The proximal V-shaped structure and the distal V-shaped structure are connected to each other by a pair of diagonal and circumferentially spaced struts that extend diagonally and are spaced apart from each other in the circumferential direction.
The diagonally and circumferentially spaced struts include a first end segment, a second end segment, and an intermediate segment located between the first end segment and the second end segment;
The first end segment is coupled to the proximal V-shaped structure, while the second end segment is coupled to the distal V-shaped structure;
The proximal V-shaped structure and the distal V-shaped structure have a first average width dimension;
The intermediate segments of the diagonally and circumferentially spaced struts have a second average width dimension that is greater than the first average width dimension;
The first end segment and the second end segment of the diagonally and circumferentially spaced struts have a third average width dimension that is larger than the first average width dimension but smaller than the second average width dimension.

According to some other embodiments, an embolic recovery device for recovering an embolus is provided,
The embolus retrieval device includes a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the cylindrical main body include a proximal V-shaped structure and a distal V-shaped structure,
The V-shaped structures are connected to each other by a pair of diagonal / circumferentially spaced struts that extend diagonally and are spaced apart from each other in the circumferential direction.
At least a part of the diagonally and circumferentially spaced struts has one or more wires or ribbons wound around it when the self-expanding member is in the radially expanded state. It has in order to increase the average bending rigidity which is the rigidity with respect to bending of the whole body part or a part thereof.

Several other embodiments of the subject matter disclosed herein are described herein with reference to the following drawings.
FIG. 1A is a two-dimensional plan view showing a self-expanding member of a treatment device according to an embodiment of the present invention. FIG. 1B is a perspective view showing the self-expanding member shown in FIG. 1A. FIG. 2 illustrates a distal wire segment extending distally from a self-expanding member according to one embodiment of the present invention. FIG. 3 shows the distal end of a self-expanding member having an atraumatic (non-invasive) tip. FIG. 4A is a two-dimensional planar development showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 4B is an enlarged view showing a segment located closest to the proximal among the self-expanding members shown in FIG. 4A. FIG. 5 shows the distal end of a self-expanding member according to one embodiment of the present invention. FIG. 6A is a two-dimensional plan view showing a self-expanding member of a treatment device according to another embodiment of the present invention. 6B is a perspective view showing the self-expanding member shown in FIG. 6A. FIG. 7A is a two-dimensional plan view showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 7B is a perspective view showing the self-expanding member shown in FIG. 7A. FIG. 7C is a two-dimensional planar development showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 8 is a two-dimensional plan view showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 9 shows a self-expanding member in an expanded state with a bulge or large diameter portion. FIG. 10 is a two-dimensional plan development view showing the self-expanding member of the treatment device according to one embodiment of the present invention. FIG. 11A is a two-dimensional plan view showing a self-expanding member of the treatment device according to an embodiment of the present invention. FIG. 11B is a perspective view showing the self-expanding member shown in FIG. 11A. FIG. 12 is a two-dimensional planar development showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 13A illustrates a method of retrieving an embolus according to one embodiment of the present invention. FIG. 13B illustrates a method of retrieving an embolus according to one embodiment of the present invention. FIG. 13C illustrates a method for retrieving an embolus according to one embodiment of the present invention. FIG. 14 is a two-dimensional planar development showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 15 is a two-dimensional planar development showing a self-expanding member of a treatment device according to still another embodiment of the present invention. FIG. 16 is a perspective view of a self-expanding member according to another embodiment of the invention having an internal wire segment. FIG. 17 is a perspective view of a self-expanding member according to another embodiment of the present invention having an external wire segment. FIG. 18 is a perspective view of a self-expanding member according to yet another embodiment of the invention having a device for capturing an embolus on the distal side. FIG. 19 is a two-dimensional plan view showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 20 shows the self-expanding member shown in FIG. 19 having a slit extending in the long axis direction (longitudinal, extending in the length direction, extending linearly). FIG. 21 shows the self-expanding member shown in FIG. 19 having a spiral slit. FIG. 22 shows the self-expanding member shown in FIG. 19 having a partially helical slit. FIG. 23 is a two-dimensional plan development view showing a self-expanding member of a treatment device according to another embodiment of the present invention. FIG. 24A is a two-dimensional planar development showing a self-expanding member of a treatment device according to still another embodiment of the present invention. 24B is a perspective view showing the self-expanding member shown in FIG. 24A. FIG. 25 illustrates how a proximally extending wire segment of a self-expanding member is coupled to a delivery wire in accordance with one embodiment of the present invention. FIG. 26 is a two-dimensional plan development view showing a self-expanding member of a treatment device according to still another embodiment of the present invention. 27A is a perspective view showing the self-expanding member shown in FIG. 27B is a plan view showing the self-expanding member shown in FIG. FIG. 28A shows a proximal wire segment of a self-expanding member according to one embodiment of the present invention. FIG. 28B shows a distal wire segment of a self-expanding member according to one embodiment of the present invention. FIG. 29 is a graph showing a curve showing a change in radial force in the self-expanding member according to the embodiment of the present invention. FIG. 30 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 31 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 32A shows a plurality of cell structures according to some embodiments shown in FIG. FIG. 32B shows a plurality of cell structures according to some embodiments shown in FIG. FIG. 32C shows a plurality of cell structures according to some embodiments shown in FIG. FIG. 33A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 33B is a plan view showing the thrombectomy device shown in FIG. 33A. FIG. 33C is a side perspective view showing the thrombectomy device shown in FIG. 33A. FIG. 34A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. 34B is a plan view showing the thrombectomy device shown in FIG. 34A. FIG. 34C is a side perspective view showing the thrombectomy device shown in FIG. 34A. FIG. 35A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 35B is a plan view showing the thrombectomy device shown in FIG. 35A. FIG. 35C is a side perspective view showing the thrombectomy device shown in FIG. 35A. FIG. 36 is a two-dimensional flat development showing a thrombectomy device according to some embodiments of the present invention. FIG. 37 is a two-dimensional flat development showing a thrombectomy device according to some embodiments of the present invention. FIG. 38 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 39 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 40A is a two-dimensional plan view showing a thrombectomy device according to an embodiment of the present invention. FIG. 40B is a diagram three-dimensionally showing the thrombus collection device shown in FIG. 40A. FIG. 41 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 42A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. Figure 42B, of the thrombus collecting device shown in Figure 4 2 A, is a two-dimensional planar development view showing an enlarged proximal tapered end. FIG. 43 is a two-dimensional planar development showing a nearest cell structure according to some embodiments of the present invention. FIG. 44 is a two-dimensional planar development showing a nearest cell structure according to some embodiments of the present invention. FIG. 45A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 45B is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 45C is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 46 is a two-dimensional flat development showing a thrombectomy device according to some embodiments of the present invention. FIG. 47A is a two-dimensional planar development showing the distal end of a thrombectomy device according to some embodiments of the present invention. 47B is a diagram three-dimensionally showing the distal end shown in FIG. 47A. FIG. 48A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 48B is a diagram three-dimensionally showing the thrombectomy device shown in FIG. 48A. FIG. 49 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 50 is a two-dimensional planar development showing a distal segment of a thrombectomy device according to some embodiments of the present invention. FIG. 51A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 51B is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 51C is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 51D is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 52A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 52B is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 53 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 54 is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 55 is a two-dimensional flat development showing a thrombectomy device according to some embodiments of the present invention. FIG. 56A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. FIG. 56B is a two-dimensional flat development showing a thrombectomy device according to some embodiments of the present invention. FIG. 57 is a two-dimensional flat development showing a thrombectomy device according to some embodiments of the present invention. FIG. 58A is a two-dimensional planar development showing a thrombectomy device according to some embodiments of the present invention. 58B is an enlarged view showing the plurality of cell structures shown in FIG. 58A. FIG. 59A is a side view showing a joint member according to an embodiment of the present invention. 59B is a cross-sectional view showing the joint member shown in FIG. 59A. FIG. 60A shows a configuration aspect of a wire mounting portion according to some embodiments of the present invention. FIG. 60B shows a configuration aspect of a wire mounting portion according to some embodiments of the present invention.

  1A and 1B show a vascular treatment device (embolus retrieval device, vascular treatment device) 10 for treating a vessel or body conduit according to one embodiment of the present invention. The vascular treatment device 10 may be used to reach and treat a patient's intracranial vasculature, for example, to treat aneurysms, embolic obstructions. Particularly suitable for use in capturing and removing embolic obstructions. However, it will be appreciated that the vascular treatment device 10 can be used for applications that reach and treat other parts of the vessel or other body conduits. Other applications include, for example, treatment of stenoses and other types of diseases or abnormalities related to the vasculature. FIG. 1A shows the vascular treatment device 10 in a two-dimensional planar development as if it had been cut and deployed flat on one surface. FIG. 1B shows the vascular treatment device 10 in a manufactured and / or expanded state. The vascular treatment device 10 has a self-expandable member 12 that is attached to or otherwise connected to a longitudinal flexible wire 40. The flexible wire 40 extends proximally from the self-expanding member 12 (proximally, in a direction approaching the operator). In one embodiment, the self-expanding member 12 is constructed of a shape memory material, such as Nitinol®, and is preferably manufactured by laser cutting the tube. In one embodiment, the self-expanding member 12 has a wire segment 42 (proximal wire segment) that is integrally formed therewith and extends proximally therefrom, the wire segment 42 having a longitudinal shape. Used to connect the flexible wire 40 to the self-expanding member 12. In this type of embodiment, the flexible wire 40 can be coupled to the wire segment 42 using solder, welding, adhesive or other known attachment methods. In another embodiment, the distal end of the flexible wire 40 is attached directly to the proximal end (proximal end) of the self-expanding member 12. The In one embodiment, the distal end of the flexible wire 40 has a flat shape with a width dimension of about 0.005 inch (about 0.127 mm), and accordingly the width dimension of the wire segment 42 is About 0.0063 inches (about 0.160 mm), the thickness dimension is about 0.0035 inches (about 0.089 mm).

  In one embodiment, the distal end of the flexible wire 40 is attached to a proximally extending wire segment 42 (proximal wire segment) by the method described below, resulting in the connection shown in FIG. Is realized. In one embodiment, a coil 41 is disposed on the wire segment 42, which is a tightly wound segment 41a that contacts the proximal end 20 of the self-expanding member 12, and a loosely wound segment. 41b having at least one gap 41c. The gap 41c has a size sufficient to fill at least the bonding agent in the internal cavity of the loosely wound segment 41b. In one embodiment, the length of the wire segment 42 and the length of the coil 41 coincide with each other. In one embodiment, the length of the wire segment 42 is 4.0 mm, with the coil 41 having the same length. When the coil 41 is installed on the wire segment 42, the distal end of the flexible wire 40 is installed in the loosely wound segment 41b so that its distal end is the proximal end of the wire segment 42. Touches the part and overlaps its proximal end lengthwise. Thereafter, a bonding agent is applied so as to pass through the gap 41 c of the coil 41, whereby the flexible wire 40 is bonded to the wire segment 42. The bonding agent can be an adhesive, solder, or other suitable bonding agent. If the bonding agent is solder, the preceding step of the process is to tie the distal end of flexible wire 40 and the proximal end of wire segment 42 to tin or other suitable wetting. Coating with a wetting agent. In one embodiment, the solder is gold, and the X-ray opacity (radiopacity) of the connecting portion is improved, so that the connecting portion is located on the proximal side. Used to act as an opaque marker. In addition to using gold, the entire or part of the coil 41 can be made of an X-ray opaque material, thereby further improving the X-ray opaqueness of the connecting portion. According to one embodiment, the length of the overlap located between the flexible wire 40 and the wire segment 42 is in a range between 0.75 mm and 1.0 mm. In the same embodiment, or in another embodiment, the length of the loosely wound segment 41b matches or substantially matches the length of the overlap portion located between the flexible wire 40 and the wire segment 42. Match. In another embodiment, instead of the coil 41 for one turn, coils having two or more turns (two or more coils) that are in contact with each other, for example, the first closely wound coil, It can be used in contact with the proximal end 20 of the self-expanding member 12 with the second loosely wound coil having a gap located proximally with respect to the first closely wound coil. Although not shown in any of the drawings, in one embodiment, a length of the distal end of the flexible wire 40 tapers away from the nominal diameter as it advances distally. A taper that decreases to a smaller dimension. Along its length, a distal wire coil having no taper and having a constant outer diameter is provided. According to one embodiment, the diameter (outer diameter) of the coil 41 matches the outer diameter of the distal wire coil.

  One advantage of the connection structure described above is that the connection structure is difficult to buckle while the vascular treatment device 10 is being pushed to pass through the delivery catheter, while the vascular treatment device 10 is It is flexible enough to allow it to be fed through a bent tortuous anatomical site. On the other hand, the connection structure can withstand a large tensile load and a large torque load without breaking. Load tests have demonstrated that the connecting structure for the previous embodiments can withstand tensile stresses greater than 2 pounds. In one embodiment, the coil 41 is constructed of a radiopaque material so that it also functions as a radiopaque marker located proximally.

  FIG. 28A shows another configuration for proximal wire segment 4002 (wire segment extending proximally from self-expanding member 4004). As shown, the proximal wire segment 4002 has a first portion 4002a and a second portion 4002b, the second portion 4002b having a width dimension W that is wider than the width dimension of the first portion 4002a. Have. In one embodiment, a tapered transition 4003 connects the first portion 4002a and the second portion 4002b to each other. In one embodiment, the width dimension W of the first portion 4002a is about 0.0063 inches, and accordingly, the width dimension W of the second portion 4002b is about 0.0085 inches and about 0.0105 inches. Is in the range between. In one embodiment, the length dimension L between the proximal end 4005 of the self-expanding member 4004 and the second portion 4002b of the proximal wire segment 4002 is about 0.017 inches and about 0.022. Within the range between inches. The advantage of having the second portion 4002b is that the wider the width dimension W, the greater the surface area that can be used to join the proximal segment wire 4002 to the longitudinal flexible wire 40. The wire 40 is used to deliver and remove the self-expanding member 4004 to and from the patient's conduit. In one embodiment, the first portion 4002a has a circular cross-sectional structure or a structure substantially equal to the circular cross-sectional structure, and the second portion 4002b has a flat shape formed by a process of pressing / coining.

  In the embodiment shown in FIGS. 1A and 1B, each self-expanding member 12 has a plurality of undulating elements 24 extending generally in the longitudinal direction, and adjacent ones of the undulating elements 24 are: They are connected to each other so as to form a plurality of cell structures 26 that are not in phase with each other and are diagonally arranged (diagonally arranged so as to be diagonally arranged). Yes. The self-expanding member 12 has a proximal end portion 14, a cylindrical body portion 16, and a distal end portion 18, and a plurality of cell structures 26 located in the body portion 16 are continuously formed. And it extends around the long axis 30 of the self-expanding member 12 over the entire circumference. The plurality of cell structures 26 located at the proximal end 14 and the distal end 18 partially extend around the major axis 30 of the self-expanding member 12 rather than around the entire circumference.

  In one embodiment, the self-expanding member 12 has an overall length of about 33.0 mm, and its body portion 16 has a length of about 16.0 mm, with a proximal end 14 and a distal end. Each 18 has a length of about 7.0 mm. In another embodiment, the length of the body 16 is generally about 2.5 to about 3.5 times greater than the length of the proximal end 14 and the distal end 18.

  In use, the self-expanding member 12 is in an unexpanded or contracted (compressed) state (not shown) having a first nominal diameter to pass through the patient's bent tortuous vessel or body conduit to the treatment site. When advanced, the self-expanding member 12 is able to move (deform) from an unexpanded state to a radially expanded state, where the self-expanding member 12 is at the treatment site. For deployment, the second nominal diameter is greater than the first nominal diameter. In another exemplary embodiment, the first nominal diameter (e.g., the average diameter of the body portion 16) is about 0.017 inches (about 0.43 mm) to about 0.030 inches (about 0.76 mm). In contrast, the second nominal diameter (eg, the average diameter of the body portion 16) is in the range of about 2.5 mm to about 5.0 mm. In one embodiment, for the portion of the cell structure 26 that is within the body portion 16 of the self-expanding member 12, the dimensional and material properties may cause the patient to partially emboli (embolization occlusion) or To generate a radial force and contact interaction large enough to cause the cell structure 26 to engage with an embolus present in the vessel in a manner that can be completely removed. Selected. In another embodiment, for the portion of the cell structure 26 that is within the body portion 16 of the self-expanding member 12, the dimensional and material properties are such that the radial force (tear) that is generated per unit length. Strength, tensile strength) in the range from about 0.005 N / mm to about 0.050 N / mm, preferably in the range from about 0.010 N / mm to about 0.050 N / mm More desirably, it is selected to be in the range of about 0.030 N / mm to about 0.050 N / mm. In one embodiment, the diameter of the body portion 16 is about 4.0 mm in a fully expanded state, so that the cell pattern (cell array), strut dimensions and materials of the cell structure 26 are: When the diameter of the body portion 16 is reduced to a value in the range of about 1.0 mm to about 1.5 mm, the generated radial force is in the range of about 0.040 N / mm to about 0.050 N / mm. Selected to be. In the same or another embodiment, when the cell pattern, strut dimensions and material of the cell structure 26 are reduced to a diameter of the body 16 to 3.0 mm, the generated radial force is about 0.010 N. / Mm to about 0.020 N / mm.

  In some embodiments shown in FIGS. 1A and 1B, each cell structure 26 is shown to have the same dimensions, with each cell structure 26 having a pair of short struts 32, and A pair of long struts 34. In one exemplary embodiment, struts 32 have a length dimension in the range between about 0.080 inches and about 0.100 inches, and struts 34 are about 0.130 inches and about 0. .With a length dimension in the range between 140 inches, each strut 32, 34 is as-cut, when it is cut for deployment and flattened. As-cut) width dimensions (circumferential dimensions of the tube to be laser cut) and thickness dimensions (radial dimensions) of about 0.003 inches and about 0.0045 inches, respectively, and after polishing (post- polishing) having a width dimension and a thickness dimension of about 0.0022 inches and about 0.0039 inches, respectively. The advantage of the ratio of the thickness dimension of each strut 32, 34 to the width dimension being greater than 1 is that the integration of the struts 32, 34 with the embolus is facilitated. is there. In another embodiment, the width dimension after polishing varies from about 0.0020 inches to about 0.0035 inches and the thickness dimension after polishing ranges from about 0.0030 inches to about 0.0040 inches. As such, the ratio of thickness dimension to width dimension varies from about 1.0 to about 2.0, and preferably from about 1.25 to about 1.75.

  In one embodiment, the ratio of the thickness dimension to the width dimension is greater than 1 for only the struts 32 and 34 located in the body portion 16. In another embodiment, only the struts 32 and 34 located at the body portion 16 and the distal end portion 18 have a ratio of thickness dimension to width dimension that is greater than one. In another embodiment, for only a portion of the plurality of struts 32 and 34, the ratio of thickness dimension to width dimension is greater than one. In yet another embodiment, a plurality of struts 32 and 34 located in different parts of the same self-expanding member 12 are different from each other with respect to the ratio of the thickness dimension to the width dimension, The ratio of each of the parts is greater than 1. As an example, the proximal end may be smaller because the radial force acting on the proximal end 14 and distal end 18 of the self-expanding member 12 may be generally less than the radial force acting on the body portion 16. 14 and / or the ratio of the thickness dimension of the plurality of struts 32 and 34 located at the distal end 18 to the width dimension is the width dimension of the thickness dimension of the plurality of struts 32 and 34 located in the body portion 16. Greater than the ratio to. An advantage of this configuration is that the ability of the self-expanding member 12 to engage the embolus is achieved such that it is more uniform along the length of the self-expanding member 12.

  In another embodiment, some or all of the plurality of struts 32 and 34 have a tapered shape (tapered shape), and the tapered shape is such that the width dimension of the outer surface of the struts 32 and 34 is the inner surface of the inner surface. It is narrower than the width dimension. In other embodiments, the self-expanding member 12 can have both a plurality of struts 32 and 34 having a generally rectangular cross-section and a plurality of struts 32 and 34 having a tapered shape.

  It is important to note that the application of the present invention is limited to self-expanding members 12 having a plurality of uniform cell structures 26 and to a plurality of cell structures 26 having special dimensional characteristics. It is not done. As an example, in another embodiment, the size of the plurality of cell structures 26 located at the proximal end 14 or / and the distal end 18 is larger than the plurality of cell structures 26 located at the body portion 16. Or small. In one embodiment, the plurality of cell structures 26 located at the proximal end 14 and the distal end 18 are larger in size than the plurality of cell structures 26 located at the body 16 so that the proximal The radial force acting on the end 14 and the distal end 18 is less than the radial force acting on the body 16.

  The radial strength of the self-expanding member 12 can be varied in various ways along the length of the self-expanding member 12. One method is to change the mass (eg, width dimension and / or thickness dimension) along the length of the self-expanding member 12. Another method is to change the size of the cell structure 26 along the length of the self-expanding member 12. In general, the cell structure 26 generates a larger radial force when the size is small than when the size is large. Varying the acting radial force along the length of the self-expanding member 12 is particularly advantageous in applications where emboli are captured and retrieved. For example, in one embodiment, the radial force is greater at the distal portion of the body portion 16 of the self-expanding member 12 in the expanded state than at the proximal portion of the body portion 16. According to such a configuration, it is facilitated that the amount of the distal portion that expands in the radial direction and enters the embolus is larger in the distal portion than in the proximal portion. Since the self-expanding member 12 is pulled in the proximal direction in the removal process of removing the embolus from the patient, according to the above-described configuration, a part of the self-expanding member 12 from the embolus is removed in the removal process of removing the embolus from the patient. The possibility of becoming discrete as particles (dislodge, dislodge, fragmentation, separation, scattering) is reduced. In another embodiment, the radial force is greater at the proximal portion of the body portion 16 of the self-expanding member 12 in the expanded state than at the distal portion of the body portion 16. In yet another embodiment, the body portion 16 of the self-expanding member 12 has a proximal portion, an intermediate portion, and a distal portion, and when the self-expanding member 12 is in the expanded state, the radial force is Larger in the proximal and distal portions than in the middle portion.

  As illustrated in FIG. 9, in some other embodiments, the body portion 16 can have a large diameter portion or bulge 70, according to the large diameter portion 70. The ability of the self-expanding member 12 to capture or otherwise engage the embolus is improved. In FIG. 9, a single large-diameter portion 70 is provided in the central portion of the main body portion 16. In some other embodiments, the large diameter portion 70 is disposed in a proximal or distal position relative to the central portion. In some other embodiments, two or more large diameter portions 70 are disposed along the length of the body portion 16. In one embodiment, the two or more large diameter portions 70 are essentially common to one another with respect to the nominal diameter at the time of manufacture. In another embodiment, among the large diameter portions 70, the most distally located one is larger with respect to the nominal diameter at the time of manufacture than the other large diameter portion 70 located proximally. In some other exemplary embodiments, the nominal diameter of the large diameter portion 70 is about 25.0 to about 45.0% greater than the nominal diameter of the body portion 16. For example, in one embodiment, the nominal diameter of the body portion 16 in the expanded state is about 3.0 mm while the nominal diameter of the large diameter portion 70 is about 4.0 mm. In another embodiment, the nominal diameter of the body portion 16 in the expanded state is about 3.50 mm, while the nominal diameter of the large diameter portion 70 is about 5.00 mm. In one embodiment, an expandable (expandable) mandrel is placed in the internal passage of the body portion 16 and the mandrel is expanded to form a large diameter portion 70 having a target diameter. The large diameter portion 70 described above is formed. In another embodiment, a mandrel having predetermined width and diameter dimensions is disposed in the body portion 16 and then the self-expanding member 12 is pressed against at least a portion of the body portion 16 against the mandrel. The one or more large-diameter portions 70 are formed by contracting.

  In one embodiment, the struts 32 and 34 at the location of one or more large diameter portions 70 are more than the other struts 32 and 34 located in the body portion 16 with respect to the ratio of thickness dimension to width dimension. large. In yet another embodiment, the struts 32 and 34 at the location of one or more large diameter portions 70 are other struts 32 and 34 located on the body portion 16 with respect to the ratio of the thickness dimension to the width dimension. Less than 34.

  In one embodiment, distal wire segment 50 attached to or integrally formed with self-expanding member 12 extends distally from distal end 22 of self-expanding member 12. And is configured to assist in guiding the self-expanding member 12 to deliver the self-expanding member 12 to the patient's treatment site. FIG. 2 shows a distal wire segment 50 according to one embodiment, the distal wire segment 50 having a first portion 52 having a uniform cross-section and a cross-sectional area that decreases in the distal direction. And a second portion 54 having a tapered cross section. In one exemplary embodiment, the first portion 52 has a length of about 3.0 mm, and has a cross-sectional dimension of about 0.0045 inches × about 0.003 inches when cut, On the other hand, the second portion 54 has a length of about 4.0 mm, and the cross-section is reduced to the most distal position. The cross-sectional dimension at the time of cutting at the most distal position is as follows. , About 0.002 inches × about 0.003 inches. The process that is performed on the vascular treatment device 10 after polishing is typically an etching process, which generally reduces the cross-sectional dimension upon cutting within a range of 40% to 50%. In another embodiment, as shown in FIG. 3, the distal wire segment 50 has a spring member 57 having a uniform cross-section and is further atraumatic (non-invasive) distal tip 58. It has. In another embodiment, the spring member (element) 57 and / or the atraumatic tip 58 is constructed or coated with a radiopaque material such as platinum, for example.

  FIG. 28b shows another configuration for the distal wire segment. As shown, the distal wire segment 4010 has a first portion 4011a and a second portion 4011b, the second portion 4011b having a width dimension W wider than the width dimension of the first portion 4011a. Have. In one embodiment, a tapered transition 4012 connects the first portion 4011a and the second portion 4011b to each other. In one embodiment, the width dimension W of the second portion 4011b is in the range between about 0.003 inches and about 0.004 inches, and accordingly the distal end 4013 of the self-expanding member 4014 and The length dimension L between the second portion 4011b of the distal wire segment 4010 is in the range between about 0.015 inches and about 0.020 inches. The advantage of having the second portion 4011b is that the wider the width dimension W, the more surface area that can be used to join the coil / spring segment (spring member) 57 to the distal segment wire 4010. is there. In one embodiment, the first portion 4011a has a circular cross-sectional structure or a structure substantially equal to the circular cross-sectional structure, and the second portion 4011b has a flat shape formed by a process of pressing / coining.

  In one embodiment, as will be described in more detail below, a self-expanding member 12 is delivered through the lumen of the delivery catheter to the patient's treatment site, the delivery catheter of the self-expanding member 12 Prior to delivery, it is placed at the treatment site. In another embodiment, the vascular treatment device 10 has a sheath that retracts the self-expanding member 12 while the self-expanding member 12 is delivered to the treatment site. The sheath can be withdrawn proximally for the self-expanding member 12 to transition to the expanded state.

  In one embodiment, the emboli present at the treatment site, for example by a process in which the self-expanding member 12 in the expanded state is itself embed into an embolus (thrombus) present at the treatment site. In addition, a part of the elongated flexible wire 40 that is outside the patient's body is separated from the patient by at least a part of the self-expanding member 12 and the embolus. The self-expanding member 12 can be removed from the patient by pulling until it is removed.

  In another embodiment, in order to form at least a part of the plurality of cell structures 26, a plurality of wavy elements 24 connected to each other such that their phases do not coincide with each other (not in phase). The use has several advantages. First, due to the nature of the cell structure 26 having a curved shape, the self-expanding member 12 during the period in which the self-expanding member 12 is delivered to the treatment site through the patient's bent tortuous anatomical site. Flexibility is improved. Further, due to the non-in-phase positional relationship in which the plurality of wavy elements 24 are non-in-phase, the plurality of elements constituting the self-expanding member 12 have a more compact nested structure. The diameter shown decreases. The specific advantages of the pattern shown by the plurality of struts 32 and 34 in the self-expanding member 12 as shown in FIG. 1A and in various other embodiments described herein are self-expanding. The elements that make up the expandable member 12 fit into each other and become sequential nesting, so that after the self-expandable member 12 is partially or fully deployed, it continues into the lumen of the delivery catheter. It is possible to be inserted. Due to the non-in-phase positional relationship described above, a diagonal orientation (array) of the plurality of cell structures 26 is further generated, and the diagonal orientation (array) is such that the self-expanding member 12 is in a contracted state and an expanded state. As it transitions between, it may induce a twisting motion that helps the self-expanding member 12 successfully engage the embolus. In another embodiment, the plurality of cell structures 26 of the self-expanding member 12 are specially arranged so that the necessary twisting motion occurs while the self-expanding member 12 expands. According to this method, for example, in order to cope with a plurality of different types of emboli, it is possible to use a plurality of different self-expanding members 12 having different degrees of torsional motion occurring in each of them. It is.

  In order to improve the ability (visibility) to see the vascular treatment device 10 under fluoroscopy (under fluoroscopy), the self-expanding member 12 is made of tungsten, platinum, platinum / iridium, tantalum and gold. Can be completely or partially covered by a radiopaque material such as Alternatively, or in combination with the use of a radiopaque coating, the radiopaque marker 60 is located at the same location as or near the proximal end 20 and distal end 22 of the self-expanding member 12. And / or disposed along proximal wire segment 42 and distal wire segment 50 and / or disposed on a selected one of a plurality of struts 32 and 34 of self-expanding member 12. Is possible. In one embodiment, the radiopaque marker 60 is a radiopaque coil, such as a platinum coil.

  FIG. 4A shows a vascular treatment device 100 according to another embodiment of the present invention in a two-dimensional planar exploded view. The vascular treatment device 100 has the same configuration as the vascular treatment device 10 shown in FIG. 1B in the state of the manufactured tube and / or the state of the expanded tube. Like the vascular treatment device 10 described above in connection with FIGS. 1A and 1B, the vascular treatment device 100 has a self-expanding member 112 that is coupled to a longitudinal flexible wire 140. Has been. The self-expanding member 112 has a proximal end 114, a tubular body 116, and a distal end 118. As described above, in order to deliver the self-expanding member 112 to the patient's treatment site in an unexpanded state, the self-expanding member 112 is inserted and deployed within the proximal end of the delivery catheter, The self-expanding member 112 is placed in the lumen of the delivery catheter until it reaches the distal end of the delivery catheter that has been previously placed at the same location as the treatment site or previously passed through the treatment site. One way is to push to pass. A proximally extending longitudinal flexible wire 140 is attached or coupled to the proximal end 120 of the self-expanding member 112, which acted on the self-expanding member 112. The pushing force is designed to be transmitted to the connecting portion of the self-expanding member 112 with the longitudinal flexible wire 140. As shown in FIG. 4A and in more detail in FIG. 4B, vascular treatment device 100 is the most proximal of a plurality of cell structures relative to some of the previous embodiments for vascular treatment device 10. Closely located cell structures 128 and 130 within the proximal end 114 are a plurality of strut elements, from the width dimension W2 of other strut elements in the self-expanding member 112. The difference is that it has a wide (enlarged) width dimension W1. As shown in the drawing, among the plurality of wall segments (wall portion, wall portion) constituting the most proximal cell structure (a plurality of cell structures) 128, the wall Segments 160, 162 and 164 are constituted by struts having a width dimension W1. Further, all the struts constituting the most proximal cell structure (one cell structure) 130 have an enlarged width dimension W1. Thanks to the presence of a plurality of struts having a width dimension W1, several advantages are obtained. One advantage is that the struts allow the pushing force applied to the proximal end 120 of the self-expanding member 112 by the distal end of the flexible wire 140 so that the self-expanding member 112 is within the patient's bent tortuous anatomy. Is more evenly distributed around the outer periphery of the self-expanding member 112. Such a more evenly distributed push force minimizes a locally generated large force component, and if the force component is not minimized, the force component is reduced to each or a plurality of struts in the self-expanding member 112. • Acts on the elements to cause them to buckle. Further, by placing a plurality of strut elements having a width dimension W1 on the outer periphery of the proximal end 114, the pushing force applied to the proximal end 114 by the flexible wire 140 thanks to the strut elements. At the same time, the tendency of the proximal end portion 114 to buckle is greatly reduced. In one embodiment, the cut width dimension W1 is about 0.0045 inches and the cut width dimension W2 is about 0.003 inches. As previously mentioned, the process performed on the vascular treatment device 100 after polishing is typically an etching process, which typically results in a cross-sectional dimension in the range of 40% to 50% when cut. Decrease within.

  It is important to note that although the width dimension W1 is shown to be the same between all the struts that are wide, this is not essential. For example, in one embodiment, the wall segment 158 has an enlarged width dimension wider than the enlarged width dimension of the wall segment 160, or the wall segment 160 has an enlarged width wider than the enlarged width dimension of the wall segment 162. Aspects having dimensions and other aspects are possible. Further, an embodiment is possible in which the inner strut element 166 of the most proximal cell structure 130 has an enlarged width dimension that is wider than the enlarged width dimension of the wall segment (strut) 158. In another embodiment, each of the radial thickness dimensions of the wall segments (struts) 158, 160, 162, 164, etc. may be replaced with, or combined with, the respective width dimension. Can be expanded.

  In yet another embodiment, as shown in FIG. 5, a portion of the plurality of strut elements 180 located at the distal end 118 of the self-expanding member 112 has a greater mass than the other strut elements 180. (Weight), thereby improving the resistance to buckling and possible breakage of the strut element 180 as the vascular treatment device 100 is advanced to the patient's treatment site. In the illustrated embodiment, the strut element 180 is shaped so that it has the same width dimension as the distal wire segment 150. In another embodiment, the strut element 180 can be expanded instead of, or in combination with, increasing its width dimension.

  6A and 6B show a vascular treatment device 200 according to another embodiment of the present invention. FIG. 6A shows the vascular treatment device 200 in a two-dimensional planar development as if it had been cut and deployed flat on one surface. FIG. 6B shows the vascular treatment device 200 in a manufactured and / or expanded state. The vascular treatment device 200 has a self-expanding member 212, which has a proximal end 214, a tubular body 216, and a distal end 218. A longitudinal flexible wire 240 is attached or otherwise connected to the proximal end 220 of the self-expanding member 212. The configuration of this vascular treatment device 200 is similar to that of the vascular treatment device 100 described above in connection with FIG. 4A, but the multiple proximal wall segments 260 of the cell structures 228 and 230 are shown in FIG. 6A. Viewed in a two-dimensional planar development, it differs in that it has a plurality of strut elements that are straight or substantially straight. In one embodiment, the plurality of proximal wall segments 260 that are straight are arranged to form a plurality of straight rail segments 270 that are continuous and substantially straight, and the straight rails The segment 270 extends from the proximal end 220 of the proximal end 214 to the most proximal end of the body 216 (also when viewed in a two-dimensional plan view in FIG. 6A) Also preferably, the linear rail segments 270 have the same length dimension as each other, but may have different length dimensions. When the pattern shown in FIG. 6A is applied to a laser that cuts the tube structure, the self-expanding member 212 will eventually have the configuration shown in FIG. 6B. As shown in FIG. 6B, the straight rail segments 270 are actually not straight, but have a curved shape with no undulations. Advantageously, according to this configuration, the linear rail segments 270 have no undulations, so that when a thrust force (axial force) acts on the linear rail segments 270, they That is, the ability of the straight rail segment 270 to distribute forces and to withstand buckling is improved. In another preferred embodiment, the angle q between the wire segments 240 and the straight rail segments 270 is in the range of about 140 degrees to about 150 degrees. In one embodiment, one or both of the straight rail segments 270 (two, first and second straight rail segments) have a width dimension W1, which is the cell structure. Of 228 and 230, larger than the width dimension of a plurality of strut elements adjacent to each other. When the pushing force (axial force) is applied to the linear rail segments 270 by the fact that the width dimension W1 of one or both of the linear rail segments 270 is larger than the width dimension of the other portion. In addition, the ability of these linear rail segments 270 to distribute forces and to withstand buckling is improved. In another embodiment, one or both of the straight rail segments 270 do not have an expanded width dimension than the other parts, but to achieve the same or similar effect, It has a thickness dimension that is larger than the area. In yet another embodiment, for one or both of the straight rail segments 270, both the width and thickness dimensions are expanded from other locations, thereby providing the same or similar effect as described above. can get. In yet another embodiment, the compressive force of the proximal end 214 of the self-expanding member 212 is further increased when the self-expanding member 212 is loaded or housed in a delivery catheter or sheath (not shown). The width dimension and / or thickness dimension of each linear rail segment 270 is varied (distributed) by position to be evenly distributed.

  7A and 7B show a vascular treatment device 300 according to another embodiment of the present invention. FIG. 7A shows the vascular treatment device 300 in a two-dimensional plan view as if it had been cut and deployed flat on one surface. FIG. 7B shows the vascular treatment device 300 in a manufactured and / or expanded state. The vascular treatment device 300 has a self-expanding member 312, which has a proximal end 314, a tubular body 316, and a distal end 318. A longitudinal flexible wire 340 is attached or otherwise connected to the proximal end 320 of the self-expanding member 312. The configuration of the vascular treatment device 300 is similar to the configuration of the vascular treatment device 200 described above with reference to FIGS. 6A and 6B, but one cell structure closest to the proximal of the plurality of cell structures. The body 330 is different in that it has a substantially diamond shape when viewed in a two-dimensional plan view in FIG. 7A. A cell structure 330 having a substantially diamond shape has a pair of outer strut elements 358 and 358 and a pair of inner strut elements (first and second inner rails) 360 and 360, The strut elements 358, 360 are expanded from other locations in terms of width and / or thickness as described above in connection with the embodiment shown in FIG. 4 and the embodiment shown in FIG. In another preferred embodiment, when viewed in a two-dimensional plan view in FIG. 7A, the inner strut element 360 is within the range of about 25.0 degrees to about 45.0 degrees to the outer strut element 358. Intersect at angle b. If the angle at which the inner strut element 360 and the outer strut element 358 are oriented is maintained within the above-described range, the self-expanding member 312 does not buckle and the self-expanding member 312 is contracted during the feeding process. The ability of the self-expanding member 312 to improve (pushability, pushability, pushability, pushability) is improved without substantially hindering the ability to reduce the diameter of the hour.

  In one embodiment, the inner strut elements 360 have a lower weight than the outer strut elements 350, so that when the self-expanding member 312 transitions from the expanded state to the contracted state, the strut elements 358 and The 360 can be easily bent. This facilitates (facilitates) a reduction in the diameter of the self-expanding member 312 when it contracts. In another embodiment, as shown in FIG. 7C, the inner strut element 360 is connected to the outer strut element 358 via a curved segment (curved connector) 361 so that the self-expanding member 312 is The inner strut element 360 can be easily bent when contracted to the feeding state (contracted state).

  FIG. 8 illustrates a vascular treatment device 400 according to another embodiment of the present invention. The configuration of the vascular treatment device 400 is similar to that of the vascular treatment device 200 shown in FIGS. 6A and 6B, except that the self-expanding member 412 of the vascular treatment device 400 is at its proximal end 414. , Except that they are connected to two longitudinal flexible wires 440 and 441 that both extend distally. As shown, the flexilve wire 440 is attached or otherwise connected to the proximal end 420 of the proximal end 414, which is the most proximal end, The flexible wire 441 is attached to the distal most distal end 422 of the proximal end 414 at the point of connection with the rail segment 470 or other Connected in a way. In yet another embodiment, another elongate flexible wire (not shown) can be attached to the distal-most end 422. Using two or more flexible wires 440 and 441 to apply a pushing force to the proximal end 414 of the self-expanding member 412 causes the pushing force acting on the proximal end 414 to be applied. This is advantageous because it is distributed over a plurality of attachment points (connection points).

  FIG. 10 illustrates a vascular treatment device 500 according to another embodiment of the present invention. In the embodiment shown in FIG. 10, the self-expanding member 512 has a plurality of undulating elements 524 each extending generally in the longitudinal direction, and adjacent ones of the undulating elements 524 are in phase with each other. The cell structures 526 are connected to each other so as to form a plurality of cell structures 526 that are not in phase and are diagonally arranged (diagonally arranged so as to be diagonally aligned with each other). The self-expanding member 512 has a cylindrical main body portion 516 and a distal end portion 518, and the plurality of cell structures 526 positioned on the main body portion 516 are continuous and can be connected to the self-expanding member 512. The long axis 530 extends around the entire circumference. The plurality of cell structures 526 located at the distal end 518 extend partially around the major axis 530 of the self-expanding member 512 rather than over the entire circumference. Of the plurality of cell structures 526, the plurality of cell structures (proximal cell structures) 528 that are located closest to the proximal end are attached to or connected to the nearest cell structures 528. A plurality of longitudinal flexible wires 540 extending in the direction. By using a plurality of the long flexible wires 540, the pushing force acting on the proximal end of the self-expanding member 512 is more evenly distributed around the proximal portion of the self-expanding member 512. Can be distributed. In another embodiment, although not shown in FIG. 10, a plurality of struts 532 of a plurality of proximal cell structures 528 have a greater width dimension and / or than struts located elsewhere in the same self-expanding member 512. Or having a thickness dimension. Also with such a configuration, the pushing force is promoted (facilitated) to be more evenly distributed around the proximal portion of the self-expanding member 512, and the pushing force is further reduced. The plurality of struts 532 that are directly received are prevented from buckling.

  11A and 11B illustrate a vascular treatment device 600 according to another embodiment of the present invention. FIG. 11A shows the vascular treatment device 600 in a two-dimensional plan view as if it had been cut and deployed flat on one surface. FIG. 11B shows the vascular treatment device 600 in a manufactured and / or expanded state. In the embodiment shown in FIGS. 11A and 11B, each self-expanding member 612 has a plurality of undulating elements 624 that extend generally in the longitudinal direction, and adjacent ones of the undulating elements 624 are curved. A plurality of closed cell structures 626 are formed which are connected to each other by connectors (connectors) 628, and are arranged around the length of the self-expanding member 612. In the illustrated embodiment, the self-expanding member 612 has a proximal end portion 612 and a tubular portion (main body portion) 616, and the plurality of cell structures 626 located in the tubular portion 616 are continuous. In addition, the self-expanding member 612 extends around the long axis 630 over the entire circumference. The plurality of cell structures 626 located at the proximal end 614 extend partially around the long axis 630 of the self-expanding member 612 rather than over the entire circumference. In another embodiment, the self-expanding member 612 is similar to the self-expanding member 12 shown in FIGS. 1A and 1B, with a proximal end, a tubular body, and a distal end. Have In this type of embodiment, a plurality of cell structures 626 located at the distal end of the self-expanding member 612 are arranged in a manner similar to the proximal end 614 shown in FIG. It extends partially around 630 rather than over the entire circumference. In addition, the plurality of self-expanding members shown in FIGS. 1A, 4A, 6A, 7A, 7C, 10, 14, 15 and 19-24 may include a distal end (eg, in FIG. 1A). Can be modified such that the distal end 18) is omitted, so that only a proximal end and a body portion are present, such as the self-expanding member 612 shown in FIG. 11A.

  FIG. 12 illustrates a vascular treatment device 700 according to another embodiment of the present invention. FIG. 12 shows the vascular treatment device 700 in a two-dimensional planar development as if it had been cut and deployed flat on one surface. In the embodiment shown in FIG. 12, each self-expanding member 712 has a plurality of undulating elements 724 that generally extend in the longitudinal direction, and adjacent ones of the undulating elements 724 are curved connectors (connections). Part) 728, thereby forming a plurality of closed cell structures 726 disposed around the length of the self-expanding member 712. In the illustrated embodiment, the self-expanding member 712 has a tubular portion (main body portion) 716 and a distal end portion 718, and the plurality of cell structures 726 located on the tubular portion 716 are continuous. The self-expanding member 712 extends around the long axis 730 over the entire circumference. A plurality of cell structures 726 located at the distal end 718 extend partially around the long axis 730 of the self-expanding member 712 rather than over the entire circumference. In a manner similar to that described in connection with the embodiment shown in FIG. 10, each of the plurality of closest cell structures 732 located closest to each other among the plurality of cell structures 726 is proximate to each other. A plurality of longitudinal flexible wires 740 extending in the lateral direction are attached or otherwise connected. With this configuration, the pushing force acting on the proximal end of the self-expanding member 712 can be more evenly distributed around the proximal portion of the self-expanding member 712 on the proximal side. In another embodiment, although not shown in FIG. 12, the multiple struts of the plurality of proximal cell structures 732 have a greater width dimension and / or larger than the struts located elsewhere in the same self-expanding member 712. It has a thickness dimension. Also with such a configuration, it is promoted (easily) that the pushing force is more evenly distributed around the proximal portion of the self-expanding member 712, and the pushing force is further reduced. The struts directly received are prevented from buckling.

  As described above, in use, the self-expanding member according to the present invention passes through the patient's bent tortuous vessel or body conduit in an unexpanded or contracted (compressed) state having a first nominal diameter. Inserted into the treatment site, for example embolic obstruction, embolization obstruction, occlusion, thrombus, and this self-expanding member moves (deforms) from a non-expanded state to a radially expanded state And the expanded state has a second nominal diameter that is greater than the first nominal diameter for the self-expanding member to deploy at the treatment site. FIGS. 13A-13C illustrate one method of delivering the self-expanding member 912 to the site where the embolus 950 is present and deploying in that location. As shown in FIG. 13A, a delivery catheter 960 having a lumen 962 is inserted up to the embolus 950 so that the distal end 964 of the delivery catheter 960 is distal to the embolus 950. It is located at the position to be close. After the delivery catheter 960 is properly positioned on the embolus 950, an embolus retrieval device (vascular treatment device) 900 is inserted into the delivery catheter 960, the insertion of the self-expanding member 912 into the delivery catheter. It is introduced into the proximal end (not shown) of 960 and then its self-expanding member 912 passes through the lumen 962 of the delivery catheter 960 by applying a pushing force to the elongate flexible wire 940. Is done by moving forward. By using radiopaque markers and / or radiopaque coatings placed on the delivery catheter 960 and the embolic retrieval device 900, the self-expanding member 912 can be attached to the delivery catheter 960 as shown in FIG. 13B. Positioned at the distal end 964, thereby aligning the body portion 916 of the self-expanding member 912 with the embolus 950 in the longitudinal direction. As shown in FIG. 13C, the self-expanding member 912 is deployed by pulling the delivery catheter 960 proximally while holding the self-expanding member 912 in place. Once the self-expanding member 912 is deployed to the expanded state within the embolus 950, the self-expanding member 912 is withdrawn to the patient's extracorporeal position along with the delivery catheter 960. In one embodiment, prior to complete removal of the embolus retrieval device 900 from the patient, the self-expanding member 912 is first partially retracted, so that the self-expanding member 912 is placed on the delivery catheter 960. Engaged with the distal end 964.

  In one embodiment, when the self-expanding member 912 is expanded in the embolus 950, it is placed in the same location for a length of time, thereby causing the blood flow that is ultimately generated to pass through the embolus 950. A perfusion passage through the embolus 950 is formed so that the embolus 950 is dissolved. In this type of embodiment, it is not necessary to capture a portion of the embolus 950 by the self-expanding member 912 in order to retrieve the embolus 950 outside the patient's body. Self-expansion if most of the embolus 950 has already been dissolved to form a target passage through the embolus 950 or if the embolus 950 is completely removed by the blood flow ultimately generated The member 912 can be withdrawn into the delivery catheter 960 and then the self-expanding member 912 can be removed from the patient.

  In another embodiment, the self-expanding member 912 is expanded in the embolus 950 and placed in the same location for a length of time, thereby causing the blood flow that is ultimately generated to pass through the embolus 950. A perfusion passage through the embolus 950 is formed such that the embolus 950 is changed, but the change in the embolus 950 makes the embolus more easily captured by the self-expanding member 912, and Or / or by a method that makes the embolus more easily separated from the patient's vessel wall. For example, a blood flow that is formed to pass through the embolus 950 can be generated to pass through the embolus 950 for a length of time sufficient to change the embolic tissue. This can be of a length that makes the embolus more easily captured by the self-expanding member 912 and / or a length that makes the embolus easier to separate from the lumen wall. Generating blood flow through the embolus 950, as when performing the method described above, further helps to preserve the tissue. In one embodiment, blood flow through embolus 950 can be used to dissolve the embolus. However, in this modified method, the embolus is dissolved for the purpose of preparing the embolus so that the embolus is more easily captured by the self-expanding member 912. . The self-expanding member 912 is deployed from the distal end 964 of the delivery catheter 940 (eg, by forming an embolus 950 having a target nominal (representative, average) diameter, if the embolus 950 is properly prepared ( Deployed), thereby causing the self-expanding member 912 to engage the embolus 950. Removing all or a portion of embolus 950 from the patient is performed in a manner similar to that described above.

  In yet another embodiment, when the self-expanding member 912 is delivered into the embolus 950 and expanded, it separates the self-expanding member 912 from the elongate flexible wire 940 and thereby the self-expanding member 912. Can be permanently placed in the patient's body. In this type of embodiment, the two parts can be separated from each other by a method of attaching a longitudinal flexible wire 940 to the self-expanding member 912. This is done, for example, by using a mechanical interlock (coupling mechanism, interlocking device) or a corrosive electrolyte joint located between the self-expanding member 912 and the elongated flexible wire 940. It is possible.

  As described herein, a self-expanding member according to various embodiments of the present invention may or may not have a distal wire segment attached to its distal end. Also good. In another preferred embodiment, a vascular treatment device designed to permanently place a self-expanding member in an embolus does not have a distal wire segment attached to the distal end of the self-expanding member.

  One of the advantages associated with the cell pattern (cell arrangement) in the self-expanding member according to the present invention is that when the self-expanding member is recovered by applying a tensile force to the longitudinal flexible wire, the self-expanding member is self-expanded. The diameter of the expansion member is reduced, and in this state the self-expansion member is withdrawn from the patient, thereby reducing the likelihood of vascular damage. Furthermore, during thrombectomy (removal), as the size of the self-expanding member decreases, multiple cell structures are folded down to pinch down on the clot, thereby removing the thrombus (removal). Ability improves. Another advantage is that the cell pattern allows the self-expanding member to be retracted within the delivery catheter lumen after the self-expanding member is partially or fully deployed. Thus, at any point in time, if it is determined that the self-expanding member has been partially or fully deployed at an improper location, the self-expanding member is placed within the distal end of the delivery catheter. It is possible to store and reposition to the correct position.

  Referring to FIG. 14, a modification of the vascular treatment device 200 shown in FIG. 6A is shown. A plurality of narrow strut elements 280 intersecting at least a portion of the cell structure 226. The narrow strut elements 280 are designed to have a narrower width dimension than the plurality of strut elements 282 forming the cell structure 226. In some other exemplary embodiments, the width dimension after cutting or polishing the narrow strut element 280 is about 25 times greater than the width dimension after cutting or polishing the other strut elements 282, respectively. -About 50% narrower. When used for thrombectomy purposes, the purpose of the narrow strut element 282 is to improve the ability of the self-expanding member 212 to engage and capture the embolus. This goal is achieved thanks to several factors. First, the narrow width of strut elements 280 makes it easier for the narrow strut elements 280 to penetrate the embolus. Second, as the self-expanding member 212 is deployed within the embolus, the narrow strut elements 280 position some of the captured emboli out of the narrow strut elements 280. It acts to pinch between the strut elements 282 which are wider than them. Third, the narrow strut elements 280 can be used to locally increase the radial force acting on the embolus. It is important to note that the use of the narrow strut element 280 is limited to use within a plurality of cell structures 226 located within the cylindrical body portion 216 of the self-expanding member 212. It is not done. These narrow strut elements 280 can be arranged in a part or all of the plurality of cell structures 226 constituting the self-expanding member 212 from the viewpoint of improving the function. Furthermore, it is important to note that the application of the narrow strut element 280 is not limited to the embodiment shown in FIG. 6, but all of the various embodiments disclosed herein. It is applicable to. Finally, in some other exemplary embodiments, a plurality of narrow strut elements 280 are disposed in one or more cell structures 226, as shown in FIG. The narrow strut elements 280 may be further used to cooperate with a cell structure 226 having a single narrow strut element 280 and / or a cell structure 226 having no narrow strut element 280. It is also possible to do.

  In the treatment of aneurysms, when the vascular treatment device 200 is used for the purpose of diverting the blood flow, a plurality of cell structures 226 may flow the blood flow away from the aneurysm sac. It has a density that is sufficient to effectively redirect. In another embodiment, instead of or in combination with adjusting the density of the cell structure 226, a plurality of intermediate strut elements similar to the narrow strut elements 280 shown in FIGS. Used to increase the effective wall surface of the self-expanding member 212. In these embodiments, the intermediate strut elements are the same size as, or smaller than, or larger than, or a combination of, the other strut elements of the cell structure 226. Have. Conversely, in another embodiment, a plurality of cell structures in an aneurysm treatment intended to place a plurality of coils or similar structures within an aneurysm sac The body 226 has a size sufficient to facilitate (facilitate) passing the coils through the plurality of cell structures 226.

  FIG. 16 shows a variation of the vascular treatment device 200 according to the embodiment shown in FIGS. 6A and 6B, in which the self-expanding member 212 is advanced to the patient's treatment site. The pushability of 212 is improved by the addition of an internal wire segment 241 that extends between the proximal end 220 and the distal end 222 of the self-expanding member 212. In this manner, the pushing force applied by the elongated flexible wire 240 is transmitted to both the proximal end 220 and the distal end 222 of the self-expanding member 212. The inner wire segment 241 may be a separate piece attached to the proximal end 220 and distal end 222 of the self-expanding member 212, and desirably extends integrally from the elongated flexible wire 240. Also good. In the process in which the self-expanding member 212 is delivered to the treatment site in a contracted state, the internal wire segment 241 sufficiently distributes (transmits) at least a portion of the pushing force to the distal end 222 of the self-expanding member 212. ) Having a substantially linear structure. When the self-expanding member 212 expands, the self-expanding member 212 contracts in the length direction as shown in FIG. 16 to cause slack in the inner wire segment 241, and within the self-expanding member 212. A helix with a long pitch is formed. Another advantage associated with using the internal wire segment 241 is that the self-expanding member 212 is expanded to form an internal helix, thereby facilitating (facilitating) the self-expanding member 212 to capture emboli. It is to be done.

  In another embodiment, as shown in FIG. 17, the pushability of the self-expanding member 212 when the self-expanding member 212 is advanced to the patient's treatment site is determined by the proximal end 220 of the self-expanding member 212. This is enhanced by the addition of an outer wire segment 243 extending between the distal end 222 and the distal end 222. In this manner, the pushing force applied by the elongated flexible wire 240 is transmitted to both the proximal end 220 and the distal end 222 of the self-expanding member 212. The outer wire segment 243 may be a separate piece attached to the proximal end 220 and the distal end 222 of the self-expanding member 212, and desirably extends integrally from the elongated flexible wire 240. Also good. In the process in which the self-expanding member 212 is delivered to the treatment site in the contracted state, the external wire segment 243 sufficiently distributes (transmits) at least a portion of the pushing force to the distal end 222 of the self-expanding member 212. ) Having a substantially linear structure. As the self-expanding member 212 expands, the self-expanding member 212 contracts in the length direction as shown in FIG. 17 to cause slack in the outer wire segment 243. Another advantage associated with using an external wire segment 243 is that the self-expanding member 212 is expanded, facilitating (facilitating) the self-expanding member 212 to engage and capture the embolus, while external That is, the wire segment 243 directly acts on the embolus.

  In another embodiment, a distal emboli capture device 251 is disposed on the distal wire segment 250 of the self-expanding member 212, or is shown in FIG. Attached to the distal end 222 of 212. The distal embolus capture device 251 may be used in the process of expanding the self-expanding member 212 or in the process of removing the self-expanding member 212 from the patient to prevent distal embolization. ) Has a function of capturing an embolus piece (emboli, thrombosis, embolus) that may be separated from the other. In FIG. 18, the distal embolic capture device 251 is shown as a coil. In another embodiment, a basket, embolic filter or other known distal embolic capture device can be attached to the distal end 222 or distal wire segment 250 of the self-expanding member 212.

  Again, as with some embodiments shown in FIGS. 14 and 15, it is important to note that the features described above in connection with FIGS. 16, 17 and 18 are similar to those in FIG. It is not limited to the embodiment shown, but is applicable to all of the various embodiments disclosed herein.

  FIG. 19 illustrates a vascular treatment device 1000 for treating a body conduit or vessel (blood vessel) according to another embodiment of the present invention. FIG. 19 shows the vascular treatment device 1000 in a two-dimensional plan view as if it had been cut and deployed flat on one surface. The vascular treatment device 1000 has a self-expanding member 1012, which has a proximal end 1024, a tubular body 1026, and a distal end 1028. Accordingly, a longitudinal flexible wire 1014 is attached or otherwise coupled to the proximal end 1020 of the self-expanding member 1012. The configuration of this vascular treatment device 1000 is similar to the configuration of the vascular treatment device 200 described above with respect to FIG. 6A, except that a plurality of cell structures 1018 and 1019 located at the proximal end 1024 include: It differs in that it is more closely packed and arranged more symmetrically than the plurality of cell structures located at the proximal end 214 of the vascular treatment device 200 (FIG. 6A). Loading a self-expanding member 1012 into a delivery catheter or sheath (not shown) by a more substantially symmetrical array of cell structures located at the proximal end 1024 of the vascular treatment device 1000 Or, disengagement is facilitated and loaded or disengaged by folding the proximal end 1024 more evenly during contraction. The plurality of proximal wall segments 1016 that make up the plurality of cell structures 1018 and 1019 are straight or substantially straight when viewed in the two-dimensional plan view of FIG. It has an element 1016. In one embodiment, the linear strut elements 1016 are arranged side by side to form a plurality of linear rail segments 1017 that are each continuous and substantially linear. The segment 1017 extends from the proximal end 1020 of the proximal end 1024 to the most proximal end of the body 1026 (again when viewed in the two-dimensional plan view of FIG. 19), and Preferably, each has the same length. In another embodiment, the angle q formed by the wire segment 1014 and the straight rail segment 1017 is in the range of about 140 degrees to about 150 degrees. In one embodiment, one or both of the linear rail segments 1017 and 1017 (two, first and second linear rail segments) have a width dimension W1, which is Among the plurality of strut elements constituting the cell structures 1018 and / or 1019 and / or 1030, the width of the adjacent strut elements is enlarged. Due to the increased width dimension W1 of one or both of the linear rail segments 1017 and 1017, the linear rail segments 1017 are forced into force when the pushing force acts on the linear rail segments 1017. The ability to disperse and to withstand buckling is improved. In another embodiment, one or both of the straight rail segments 1017 do not have an expanded width dimension than the other parts, but to achieve the same or similar effect, It has a thickness dimension that is larger than the area. In yet another embodiment, for one or both of the linear rail segments 1017, both the width and thickness dimensions are expanded from other locations, thereby providing the same or similar effect as described above. can get. In yet another embodiment, the proximal end 1024 of the self-expanding member 1012 when the self-expanding member 1012 is folded so that the self-expanding member 1012 is loaded or contained within a delivery catheter or sheath. The width and / or thickness dimensions of each linear rail segment 1017 are varied (distributed) depending on the position so that the compression force is more evenly distributed.

  Although the following description is directed to the embodiment shown in FIG. 19, it is important to note that the slits employed by some embodiments shown in FIGS. It is applicable to all the vascular treatment devices described in, many embodiments of these vascular treatment devices and variations thereof.

  Referring now to FIG. 20, the vascular treatment device 1000 shown in FIG. 19 has a longitudinally extending slit 1040 that is distal from the proximal end 1020 of the self-expanding member 1012. It extends to the end 1022. The slit 1040 allows the cell structures 1018, 1019, and 1030 to move relative (approach and separate) such that the self-expanding member 1012 is loaded into the delivery catheter or sheath. Or in a manner that prevents each strut element 1032 of the self-expanding member 1012 from buckling when the self-expanding member 1012 is retracted. In another embodiment, the slit 1040 extends less than the entire length of the self-expanding member 1012 and is arranged to prevent buckling of the strut elements that are strategically important. The strut element has the greatest impact on the ability of the self-expanding member 1012 to be effectively loaded or retrieved within the delivery catheter or sheath. For example, in one embodiment, the slit 1040 is located only at the proximal end 1024 of the self-expanding member 1012 where the strut element 1032 is most likely to buckle or bend. In another embodiment, slits 1040 are disposed on both the proximal end 1024 of the self-expanding member 1012 and the tubular body 1026.

  FIG. 21 is a vascular treatment device 1000 shown in FIG. 19, in a diagonal arrangement (orientation extending in a direction crossing obliquely with respect to the major axis) of the self-expanding member 1012 and in a spiral shape. One having a slit 1050 is shown. In one embodiment, as shown in FIG. 21, a helical slit 1050 extends from a proximal point of the proximal end 1024 of the self-expanding member 1012 or a position adjacent to the distal point. ing. With respect to this embodiment having a straight rail segment, such as the straight rail segment 1017 shown in FIG. 19, the helical slit 1050 is at a distal location 1021 of any of the plurality of straight rail segments 1017, or It extends from a position adjacent to its distal position 1021 in the distal direction. Testing the various vascular treatment devices described herein has shown that buckling tends to occur at the strut element adjacent to the distal position of the proximal end of the self-expanding member. found. This phenomenon is exacerbated in self-expanding members having straight rail segments at the proximal end. For this reason and with reference to FIG. 21, the beginning of the helical slit 1050 is located at or adjacent to the distal position 1021 of any straight rail segment 1017. To do. The advantages of the diagonal arrangement and / or helical slit 1050 configuration shown in FIG. 19 are that the helical slit 1050 extends from a location where buckling is likely to occur, and that the strut elements 1032 are self-expanding members. Prevents buckling in the 1012 length direction. As shown in FIG. 22, in another embodiment, the slit 1050 is diagonally (diagonally) along only a part of the outer periphery of the main body 1026 that forms the cylindrical shape of the self-expanding member 1012. It extends. In the embodiment shown in FIG. 22, a slit 1050 extends from the distal position 1021 of the straight rail segment 1017. In another embodiment, when the buckling of each strut element 1032 starts from a position that is not a distal position of the proximal end 1024 of the self-expanding member 1012, the leading end of the slit 1050 is It is located at the buckling start point (the position where buckling will start if the slit 1050 is not present) and extends from the start point in the distal direction along the long axis.

  FIG. 23 illustrates a vascular treatment device 2000 for treating a body conduit or vessel (blood vessel) according to another embodiment of the present invention. FIG. 23 shows the vascular treatment device 2000 in a two-dimensional plan view as if it was cut and spread flat on one surface. The vascular treatment device 2000 has a self-expanding member 2012 that is attached to or otherwise connected to a longitudinal flexible wire 2040 and the flexible wire 2040. Extends proximally from the self-expanding member 2012. In one embodiment, the self-expanding member 2012 is constructed from Nitinol® and is desirably manufactured by cutting the tube with a laser. In one embodiment, the self-expanding member 2012 has a wire segment 2042 (proximal wire segment) integrally formed therewith and extending proximally therefrom, the wire segment 2042 having a longitudinal shape. Used to connect the flexible wire 2040 to the self-expanding member 2012. In this type of embodiment, the flexible wire 2040 can be coupled to the wire segment 2042 using solder, welding, adhesive or other known attachment methods. In another embodiment, the distal end of the flexible wire 2040 is attached directly to the proximal end 2020 of the self-expanding member 2012.

  In the embodiment shown in FIG. 23, each self-expanding member 2012 has a plurality of undulating elements 2024 extending generally in the longitudinal direction, and adjacent ones of the undulating elements 2024 are aligned in the circumferential direction. The plurality of cell structures 2026 are connected to each other. The self-expanding member 2012 has a proximal end portion 2013, a cylindrical main body portion 2014, and a distal end portion 2015, and a plurality of cell structures 2026 located on the main body portion 2014 are continuously formed. Further, the self-expanding member 2012 extends around the long axis 2032 over the entire circumference. The plurality of cell structures 2026 located at the proximal end 2013 and the distal end 2015 extend partially around the long axis 2032 of the self-expanding member 2012 rather than over the entire circumference. The plurality of proximal wall segments 2016 that make up the plurality of cell structures 2027, 2028, 2029, and 2030 are straight or substantially straight when viewed in the two-dimensional planar development of FIG. It has a plurality of straight strut elements 2016. In one embodiment, the linear strut elements 2016 are arranged side by side to form a plurality of linear rail segments 2017 that are each continuous and substantially linear. The segment 2017 extends from the proximal end 2020 of the proximal end portion 2013 to the most proximal end of the body portion 2014 (again when viewed in the two-dimensional plan view of FIG. 23), and Preferably, each has the same length. As described above with reference to FIGS. 6A and 6B, the linear rail segments 2017 are actually not straight, but have a curved shape with no undulations. Advantageously, according to this configuration, the linear rail segments 2017 have no corrugations, so that when thrust (axial force) acts on the linear rail segments 2017, they That is, the ability of the straight rail segment 2017 to distribute force and to withstand buckling is improved. In another preferred embodiment, the angle q between the corresponding wire segment 2042 or 2040 and the linear rail segment 2017 is in the range of about 140 degrees to about 150 degrees. In one embodiment, the straight rail segment 2017 has a width dimension that is a plurality of struts that make up the cell structures 2027 and / or 2028 and / or 2029 and / or 2030 and / or 2026. -It is expanded from the width dimension of the elements adjacent to each other. Even when the width dimension of the linear rail segment 2017 is larger than the width dimension of other portions, when the push force (axial force) acts on the self-expanding member 2012, the linear rail The ability of the segment 2017 to distribute the force and to withstand buckling is improved. In another embodiment, the straight rail segment 2017 does not have a width dimension that is enlarged from other parts, but is thicker than other parts in order to obtain the same or similar effect. It has a size. In yet another embodiment, for the straight rail segment 2017, both the width and thickness dimensions are expanded from other locations, thereby obtaining the same or similar effect as described above.

  In one embodiment, the width and / or thickness dimensions of the inner strut elements 2080 that make up the most proximal cell structure 2027 also allow the self-expanding member 2012 to pass through the sheath or delivery catheter. While being extruded, it is enlarged from the dimensions of other sites to counter the buckling of the inner strut elements 2080. In an exemplary embodiment, the strut elements 2016 and 2080, which are larger in size than other parts, have a nominal width dimension at the time of cutting of about 0.0045 inches, while the other strut elements are cut. The nominal width dimension is about 0.003 inches.

  24A and 24B show a vascular treatment device 3000 according to another embodiment of the present invention. FIG. 24A shows the vascular treatment device 3000 in a two-dimensional planar development as if it had been cut and deployed flat on one surface. FIG. 24B shows the vascular treatment device 3000 in a manufactured and / or expanded state. The overall design structure of this vascular treatment device 3000 is similar to the design structure of the vascular treatment device 2000 shown in FIG. 23 and described above with reference to that figure. The main difference between the two design structures is the ratio of the length dimension L of the cell structures 2026, 2027, 2028, 2029 and 2030 to the width dimension W. The ratio of the length dimension of the cell structure shown in FIG. 24A to the width dimension is generally larger than the ratio of the length dimension of the cell structure shown in FIG. 23 to the width dimension. As shown, the length dimension L for the cell structure of the vascular treatment device 3000 shown in FIG. 24A is generally the length for each cell structure shown in FIG. The width dimension W for the cell structure of the vascular treatment device 3000 shown in FIG. 24A is generally smaller than the width dimension for each cell structure shown in FIG. As a result, the slope of each strut element 2040 in the cell structure shown in FIG. 24A is generally smaller than the slope of each strut element in the cell structure shown in FIG. By reducing the slope of the strut element 2040 and maintaining other dimensional and material properties, the effective force component (effective radial force) along the length of the strut element 2040 is reduced. The effect brought about by this decrease is that, in the vascular treatment device 3000 shown in FIG. 24A, a level at which the value obtained by summing the plurality of axial force components along the AA line approximates the value summed along the BB line. , Higher than the vascular treatment device 2000 shown in FIG. The inventors have found through experiments that the ratio of the length dimension of the cell structure at the time of cutting to the width dimension is greater than about 2.0, and the length dimension of the cell structure at the time of expansion. A radial force distribution along the length of the self-expanding member 2012 in combination with a ratio to the width dimension of greater than about 1.25, wherein the self-expanding member 2012 is What results is an advantage to improve the ability to be pushed through the lumen and collected into the lumen.

  26, 27A and 27B show a self-expanding member 5000 according to another embodiment of the present invention. Each of the self-expanding members 5000 includes a plurality of wave elements 5024 extending generally in the longitudinal direction, and adjacent ones of the wave elements 5024 are in non-in-phase states that are out of phase with each other, and A plurality of diagonally arranged cell structures 5026 that are coupled together to form an angle between each other in the range of about 40.0 degrees to about 50.0 degrees. In one embodiment, the cell structures 5026 are arranged diagonally along a straight line having about 45.0 degrees. The self-expanding member 5000 has a proximal end portion 5014, a tubular main body portion 5016, and a distal end portion 5018. The plurality of cell structures 5026 located on the main body portion 5016 are continuously formed. And it extends around the long axis of the self-expanding member 5000 over the entire circumference. The plurality of cell structures 5026 located at the proximal end 5014 and the distal end 5018 partially extend around the major axis of the self-expanding member 5000 rather than around the entire circumference. In one embodiment, the self-expanding member 5000 has a nominal diameter of about 1.0 mm in an unexpanded or crimped state, and by design has a maximum diameter of about 4.0 mm in an implantable state.

  In one embodiment, the self-expanding member 5000 has a total length A of about 36.0 plus or minus 2.0 mm, and its body portion 5016 has a length P of about 19.0 plus or minus 2.0 mm. Have In one embodiment, the strut width dimension N and thickness dimension O in the body 5016 are about 0.0021 plus or minus 0.0004 inches and about 0.0032 plus or minus 0.0005 inches, respectively. On the other hand, the strut width dimension L of the proximal rail segment 5030 is approximately 0.0039 plus or minus 0.004 inches.

  In use, the self-expanding member 5000 is in a non-expanded or contracted (compressed) state (not shown) having a first nominal diameter to pass through the patient's bent tortuous vessel or body conduit to the treatment site. When advanced, the self-expanding member 5000 is able to move (deform) from an unexpanded state to a radially expanded state, where the self-expanding member 5000 is at the treatment site. For deployment, the second nominal diameter is greater than the first nominal diameter. In another exemplary embodiment, the first nominal diameter (e.g., the average diameter of the body portion 16) is about 0.017 inches (about 0.43 mm) to about 0.030 inches (about 0.76 mm). In contrast, the second nominal diameter (eg, the average diameter of the body portion 5016) is in the range of about 2.5 mm to about 5.0 mm. In one embodiment, for the portion of the cell structure 5026 that resides within the body portion 5016 of the self-expanding member 5000, the dimensional and material properties may cause the patient to emboli (embolization occlusion) partially or To generate a radial force and contact interaction large enough to cause the cell structure 5026 to engage with an embolus present in the vessel in a manner that can be completely removed, Selected. In another embodiment, for the portion of the cell structure 5026 that is within the body portion 5016 of the self-expanding member 5000, the dimensional and material properties are such that the radial force (tearing) generated per unit length. Strength, tensile strength) in the range from about 0.005 N / mm to about 0.050 N / mm, preferably in the range from about 0.010 N / mm to about 0.050 N / mm More desirably, it is selected to be in the range of about 0.030 N / mm to about 0.050 N / mm. In one embodiment, the diameter of the body portion 5016 is about 4.0 mm in the fully expanded implantation state by design, and accordingly, the cell pattern (cell arrangement) of the cell structure 5026, the strut dimensions. And the material is selected such that when the diameter of the body 5016 is reduced to 1.5 mm, the generated radial force is in the range of about 0.040 N / mm to about 0.050 N / mm. In the same or another embodiment, when the cell pattern, strut dimensions and material of the cell structure 5026 are reduced to a diameter of the body 5016 to 3.0 mm, the generated radial force is about 0. It is selected to be in the range from 010 N / mm to about 0.020 N / mm.

  In one embodiment, as shown in the graph of FIG. 29, the cell structure 5026 is configured to have specific dimensional and material properties that are determined by the self-expanding member 5000. The total radial force acting on the self-expanding member 5000 over the entire length of the self-expanding member 5000 when in the contracted or crimped state is in a range between about 1.50 N and about 2.50 N. Create a state. In the initial diameter expansion range in which the self-expanding member 5000 initially expands about 0.50 mm in the radial direction from the contracted state, that is, the crimped state, the self-expanding member 5000 assumes that the self-expanding member expands 1 mm in the radial direction. The total value over the entire length of the self-expanding member 5000 in an amount that reduces the radial force acting on the expanding member 5000 is in the range of about -1.5N to about -3.5N. When the self-expanding member 5000 expands by about 0.5 mm following the initial diameter expansion range, it is assumed that the self-expanding member 5000 expands by 1 mm in the radial direction. The total value over the entire length of the self-expanding member 5000 in the amount that the applied radial force is reduced is in the range of about -0.10 N to about -0.50 N, which indicates that the self-expanding member 5000 is designed as described above. Move on to the fully expanded implant state above and continue until a non-zero radial force. Advantageously, during the initial diameter expansion range, the self-expanding member 5000 generates a relatively large radial force so that the struts of the self-expanding member 5000 are in the initial deployed state of the vascular treatment device. The possibility of the element engaging an embolus in the patient's conduit is increased. Furthermore, the initial value of the rate at which the radial force decreases (decreasing slope) is much greater in the initial diameter expansion range than in the subsequent diameter expansion range. In the exemplary embodiment illustrated by FIG. 29, generally in the initial diameter expansion range, the initial value of the radial force decrease rate (decrease slope) is the radial force decrease rate (reduction) in the subsequent diameter expansion range. About 20.0 to about 30.0 times greater than the gradient. The advantage afforded by such radial force characteristics can be realized in the initial deployment stage of the self-expanding member 5000, so that the strut elements of the self-expanding member 5000 can be In the embolus of the cerebral emboli, and accordingly, in the stage following the initial deployment stage, the amount of decrease in radial force is large, and the large amount of reduction does not cause complications, and While the poor interaction with the conduit is limited (eg, less damage to the conduit wall), the ability to remove emboli from the patient's conduit is improved. Another advantage provided by the radial force characteristic is that the rate at which the total value of the radial force decreases over the entire length of the self-expanding member 5000 (decreasing slope) decreases with a characteristic resembling linearity and is greatly reduced. At the reduced rate, the accuracy with which the radial force acting on the self-expanding member 5000 can be predicted is equalized regardless of the diameter of the self-expanding member 5000. Furthermore, it is advantageous that the radial force acting on the self-expanding member 5000 achieves a non-zero value when the self-expanding member 5000 exhibits a design maximum implantable diameter diameter. It is designed.

  FIG. 30 illustrates a thrombectomy device 6000 according to some embodiments of the present invention, in particular, a plurality of strut elements (struts, rails) comprising rail segments 6001 and 6002. The struts have different varying width dimensions. FIG. 30 shows the thrombectomy device 6000 in a two-dimensional plan view as if it had been cut and deployed flat on one surface. FIG. 30 shows the thrombectomy device 6000 as it is manufactured (as-cut, cut for deployment and flattened). In one embodiment, the rail segment 6001 is the same as the distal end 6015 of the rail segment 6001 from the maximum width dimension (maximum rail width dimension) at or near its proximal end 6014. It changes to the minimum width dimension (minimum rail width dimension) at the position or the position in the vicinity thereof. Similarly, a rail segment 6002 has a maximum width dimension at the same location as or near its proximal end 6014, and from the maximum width dimension at or near its distal end 6016. Changes to narrow dimensions. As described above, the respective width dimensions of the rail segments 6001 and 6002 are such that the push force acts on the proximal end 6014 of the vascular treatment device (thrombosis collection device 6000). In addition, it is selected to enhance its ability to distribute forces and withstand buckling. In some embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is about 20.0% and about 50.0%. % Is between. In some other embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is between about 25.0% and about 45.0%. . In some other embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is between about 35.0% and about 45.0%. . In one preferred embodiment, each of the rail segments 6001 and 6002 has a width dimension of about 0.0027 plus or minus 0.0004 inches to a maximum width dimension of about 0.0027 plus or minus 0.0004 inches. Changes to narrow dimensions. In another preferred embodiment, the width dimension of each of the rail segments 6001 and 6002 is from a maximum width dimension of about 0.0047 plus or minus 0.0004 inches to about 0.0035 plus or minus 0.0004 inches. Changes to the minimum width dimension. In another preferred embodiment, the width dimension of each of the rail segments 6001 and 6002 is about 0.0037 plus or minus 0.0004 inches from a maximum width dimension of about 0.0047 plus or minus 0.0004 inches. Changes to the minimum width dimension. As described above, the process performed on the thrombectomy device 6000 after polishing generally includes an etching process, which generally results in as-cut cross-section dimensions. Decreases within a range of 40% to 50%.

  As previously described herein, FIG. 30 shows a plurality of rail segments that do not have undulations, but it should be understood that rail segments such as those shown in FIGS. 1A and 4A are also implemented. It means that the form is applied. Further, it will be appreciated that, apart from the above-described characteristics regarding rail width dimensions, a plurality of vascular treatment devices (thrombuses) previously disclosed herein in connection with FIGS. 30 and any number of features and / or characteristics (eg, related to dimensions, spatial, relational, etc.) of FIG. It can be incorporated into a thrombectomy device 6000 according to the above.

  In some embodiments, the width dimension of each of the rail segments 6001 and 6002 decreases at a substantially constant rate of decrease along the respective total length (or a portion of the total length) ( It is tapered in substantial uniform and diminishing fashion. In some implementations, each of the rail segments 6001 and 6002 has a plurality of discrete rail portions, each having a substantially uniform width dimension, the rail portions having a width. A plurality of transitional tapers (parts having a gradually changing width dimension interposed between rail portions) are used to connect different dimensions to each other. In some implementations, each of the rail segments 6001 and 6002 has a plurality of discrete rail portions, each having a substantially uniform width dimension, the rail portions having a width. A plurality of stepped transitions (parts whose width dimension changes stepwise between the rail portions) are used to connect different dimensions to each other. In some other embodiments, two or more of the above-described methods of transitioning width dimensions are utilized. Although not essential, it is desirable for the transitions to appear at multiple portions along the rail struts, rather than at the connection points of the multiple rail struts described above (eg, multiple connection points 6030). .

  In some embodiments, as described above, the struts 6012 and 6013 of the most proximal cell structure 6018 located closest to the plurality of cell structures are connected to the bend of the thrombectomy device 6000 of the patient. For the purpose of improving the pushability of the thrombectomy device 6000 when it is advanced in a tortuous anatomy, it is a width dimension expanded from other parts, Some of them may be less than or equal to the maximum rail width dimension. In some embodiments, the portion of the struts 6012 and 6013 that are shorter than the entire length is given a width dimension that is larger than other portions. For example, in some embodiments, an enhanced width portion that is wider in width than other sites is from the most proximal end of each of struts 6012 and 6013, which is the most proximal end. It extends and ends at a position in front of the connection point 6026 by a certain distance. The configuration of the struts 6012 and 6013 can also be changed by some of the methods described above.

  With continued reference to FIG. 30, in some preferred embodiments, all or part of each of struts 6003 and 6004 (and optionally, the proximal portion of each of struts 6005 and 6006). All or part of which can be added) have a width dimension between about 0.0045 inches and about 0.0050 inches, and all or part of each of struts 6007 and 6008 (and Optionally, all or part of the distal portion of each of the struts 6005 and 6006 can be added) having a width dimension between about 0.0035 inches and about 0.0036 inches. And all or part of each of struts 6009 and 6010 (and optionally, struts 600 And all or a portion of the distal portion of each of 6008 can be added) has a width dimension between about 0.0027 inches and about 0.0035 inches, and the device ( The thrombectomy device 6000) (substantial portion, substantial portion, more than half portion) of each of the plurality of strut elements located in the remaining portion of sections A, B and C is: It has a width dimension between about 0.0027 inches and about 0.0034 inches. In one or more of the several embodiments just described, the width dimension of each of struts 6012 and 6013 is between about 0.0033 inches and about 0.0047 inches, preferably Is between about 0.0033 inches and about 0.0040 inches. It should be understood that the dimensions disclosed throughout this specification relate to some preferred embodiments and may depend on conventional manufacturing dimensional tolerances. There may be multiple variations on these dimensions, which are contemprated by this embodiment.

  Although not essential, multiple width dimension transitions may appear at multiple portions along the rails themselves rather than at the aforementioned multiple strut connection points (eg, multiple connection points 6030 and 6032). desirable.

  In a preferred embodiment, the struts 6003-6006 each have a width dimension of about 0.0047 inches, and the strut 6007, the strut 6008, and the proximal portion of the strut 6010 are each about zero. Each of the strut 6009, the strut 6011, and the distal portion of the strut 6010 has a width dimension of about 0.0035 inches, and the strut 6012, Struts 6013 each have a width dimension of about 0.0036 inches, and all or a substantial portion of the remaining plurality of strut elements of the treatment device (thrombosis collection device 6000), The substantial part, more than half part) is each about 0.0027 inches wide With the law.

  Experiments have shown that the proximal taper region (proximal taper region, a portion having a taper in the proximal position) of the treatment device (thrombus collection device 6000) shown in FIG. It is proven to have a radial force characteristic, which is characterized in that the proximal taper is inserted into the introducer sheath and / or delivery catheter and covered therewith and its re- It makes it possible to perform the re-sheathing, which is an implementation, well.

  In another preferred embodiment, struts 6003-6006 each have a width dimension of about 0.0047 inches, and strut 6007, strut 6008, and the proximal portion of strut 6010 are each about A width dimension of 0.0036 inches, and struts 6009, struts 6011 and the distal portion of struts 6010 each have a width dimension of about 0.0035 inches, and struts 6012 and 6013 each have a width dimension of about 0.0036 inches, and a plurality of strut elements located in section A of the thrombectomy device 6000, the remaining being about 0.0033 inches Each having a width dimension, and struts 6012 and 6013 are each about 0.0 It has a width dimension 36 inches, also a plurality of strut elements located in section B and C of the thrombus collecting device 6000 and the remaining ones, have a width of approximately 0.0027 inches. Advantageously, the increased width dimension of the plurality of struts in section A reduces the possibility of struts buckling within the proximal taper of the thrombectomy device 6000, and further the proximal The radial strength of the taper is also increased.

  In another preferred embodiment, struts 6003-6006 each have a width dimension of about 0.0047 inches, and strut 6007, strut 6008, and the proximal portion of strut 6010 are each about The strut 6009, the strut 6011, and the distal portion of the strut 6010 each have a width dimension of about 0.0035 inches, and the thrombectomy A plurality of strut elements located in section D of device 6000, the remaining having a width dimension of about 0.0033 inches, and a section of the treatment device (thrombosis collection device 6000) A plurality of strut elements generally located in B and C, the remaining It has a width dimension of 0.0027 inches. Advantageously, the expanded width dimension of the plurality of struts in section A allows the proximal taper of the thrombectomy device 6000 to be delivered while the thrombectomy device 6000 is delivered to the patient's treatment site. The possibility that the struts buckle in the part is reduced, and further, the radial strength of the proximal taper part is increased.

  In another preferred embodiment, struts 6003-6006 each have a width dimension of about 0.0047 inches, and strut 6007, strut 6008, and the proximal portion of strut 6010 are each about A width dimension of 0.0036 inches, and struts 6009, struts 6011 and the distal portion of struts 6010 each have a width dimension of about 0.0035 inches, and struts 6012 and 6013 each has a width dimension of about 0.0036 inches, and a plurality of strut elements generally located in section C of the thrombectomy device 6000 have a width dimension of about 0.0033 inches. And also located in sections A and B of the thrombectomy device 6000 The remainder a plurality of strut elements has a width of approximately 0.0027 inches. Advantageously, the expanded width dimension of the plurality of struts in section C allows the distal taper of the thrombectomy device 6000 to be delivered while the thrombectomy device 6000 is delivered to the patient's treatment site. The possibility of buckling of the struts in the (distal taper region) is reduced. The enlarged width dimension further provides a radial strength of the proximal taper that allows the distal taper to open while the thrombectomy device 6000 is withdrawn from the patient. The ability to be maintained in the state of possession is increased. This feature is particularly advantageous when the thrombectomy device 6000 is used for emboli removal, in that the thrombectomy device 6000 is being removed from the patient. In the state, this feature allows the distal taper to be held open and allows the remaining portion of the embolus to be swept away.

  According to some embodiments, a thrombectomy device 6000 according to FIG. 30 laser cuts a tube having an inner diameter of about 2.667 mm and a wall thickness in the range of about 0.102 mm to about 0.126 mm. Manufactured by. In use, until the thrombectomy device 6000 according to the embodiment shown in FIG. 30 passes through the patient's tortuous vascular anatomy or bodily duct and reaches the treatment site, It is advanced in an unexpanded or compressed state having a first nominal dimension and is in a radially expanded state from the unexpanded state to deploy a thrombectomy device 6000 at the treatment site. And can be displaced to one having a second nominal dimension greater than the first nominal dimension. In some other preferred embodiments, the second nominal dimension (eg, the average diameter of the body) is about 4.0 plus or minus 0.5 mm. In some embodiments, the dimensional and material properties of a plurality of cell structures 6020 that are generally indwelled in a body portion (Section B) of an expandable material may cause the cell structures 6020, the emboli to be a patient. Selected to generate sufficient radial force and contact interaction to engage an embolus / thrombosis placed in the vessel in a manner that partially or completely removes from the vessel .

  In some embodiments, the dimensional and material properties of the elements along the expandable length of the thrombectomy device 6000 are such that the outer diameter of the thrombectomy device 6000 is constrained to 1.5 mm. , Selected to generate a radial force within a range from about 0.030 N / mm to about 0.055 N / mm per unit length. In some embodiments, the dimensional and material properties of the elements along the expandable length of the thrombectomy device 6000 are such that the outer diameter of the thrombectomy device 6000 is constrained to 1.5 mm. , Selected to generate a radial force within a range of about 0.035 N / mm to about 0.050 N / mm per unit length. In some embodiments, the dimensional and material properties of the elements along the expandable length of the thrombectomy device 6000 are such that the outer diameter of the thrombectomy device 6000 is constrained to 1.5 mm. , Selected to generate a radial force within a range from about 0.037 N / mm to about 0.049 N / mm per unit length. In some embodiments that are the same or different from each other, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 6000 are such that the nominal diameter dimension of the body is about 3.0. When plus or minus 0.5 mm, it is selected to generate a radial force in the range from about 0.010 N / mm to about 0.020 N / mm per unit length.

In the embodiment shown in FIG. 30, many of the plurality of cell structures (except for the plurality of cell structures formed at least partially by rail segments 6001 and 6002) are the plurality of cells. The majority of the structure is shown to have a shape similar to that including a pair of short struts 6022 and a pair of long struts 6023. According to some embodiments, the area of each of the plurality of cell structures is about 4.00 plus minus 0.5 mm ² . In a desirable embodiment, the area of each cell structure is 4.2 mm ² . In some preferred embodiments, each short strut 6022 has a length in the range between about 0.080 inches and about 0.100 inches, and each long strut 6023 is about A plurality of lengths in a range between 0.130 inches and about 0.140 inches, thereby extending along the perimeter of the treatment device (thrombectomy device 6000) A staggered cell array of cell structures is generated. In some embodiments, the total length of the expandable portion of the thrombectomy device 6000 is in a range between about 35.0 mm and about 45.00 mm, and accordingly, the body portion (section B) has a length in the range between about 20.0 mm and about 25.0 mm. In one desirable embodiment, the total length of the expandable portion of the thrombectomy device 6000 is about 42.7 mm, and accordingly the body (section B) has a length of about 21.7 mm. And the proximal taper and the distal taper have a length of about 12.4 mm and a length of about 8.6 mm, respectively.

  FIG. 31 shows a thrombectomy device 6050 according to some other embodiments, in which the plurality of strut elements comprising the rail segments 6051 and 6052 are each different from one another. It has a width dimension. The thrombectomy device 6050 is particularly adapted for the treatment of small diameter vessels / ducts. In one embodiment, as shown in FIG. 31, the outer periphery of the main body (section A) has three cell structures 6080, but the configuration of the main body is not limited to this. FIG. 31 shows the thrombectomy device 6050 in a two-dimensional plan view as if it had been cut and deployed flat on one surface. FIG. 31 shows the thrombectomy device 6050 as it is manufactured (as-cut, cut for deployment and flattened). In one embodiment, the rail segment 6051 is located at the same position as or near its distal end 6054 from its maximum width dimension at or near its proximal end 6053. Vary to the minimum width dimension at. Similarly, a rail segment 6052 has a maximum width dimension at the same location as or near its proximal end 6053 and from the maximum width dimension at or near its distal end 6055. Changes to narrow dimensions. As described above, the respective width dimensions of the rail segments 6051 and 6052 are such that the push force acts on the proximal end 6053 of the vascular treatment device (thrombosis collection device 6050). In addition, it is selected to enhance its ability to distribute forces and withstand buckling. In some embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is about 20.0% and about 30.0%. %, Desirably between about 20.0% and about 25.0%. In a preferred embodiment, each of the rail segments 6051 and 6052 has a width dimension of about 0.0036 plus or minus 0.0004 inches to a maximum width of about 0.0036 plus or minus 0.0004 inches. Changes to narrow dimensions.

  As described above in this specification, FIG. 31 shows a plurality of rail segments 6051 and 6052 that do not have a corrugated portion, but rail segments as shown in FIGS. 1A and 4A are also applicable to this embodiment. It is understood that it is a target. Further, apart from the rail width dimension characteristics described above, a plurality of vascular treatment devices (thrombus collection devices) previously disclosed herein in connection with FIGS. Any number of features and / or characteristics (eg, dimensions, spatial, relational, etc.) can be transferred to the thrombectomy device 6050 according to FIG. It is understood that it can be incorporated.

  In some embodiments, the width dimension of each of rail segments 6051 and 6052 decreases at a substantially constant rate along their respective total length (or a portion of the total length) ( It is tapered in substantial uniform and diminishing fashion. In some embodiments, each of the rail segments 6051 and 6052, each of the plurality of discrete rail portions having a substantially uniform width dimension, is the rail portion and has a width. A plurality of transitional tapers (parts having a gradually changing width dimension interposed between rail portions) are used to connect different dimensions to each other. In some embodiments, each of the plurality of rail segments 6051 and 6052 that are discrete from each other individually has a substantially uniform width dimension, while the rail portions 6051 and 6052 each have a substantially uniform width dimension. A plurality of stepped transitions (parts whose width dimension changes stepwise between the rail portions) are used to couple those having different width dimensions to each other. In some other embodiments, two or more of the above-described methods of transitioning width dimensions are utilized. Although not essential, it is desirable for the transitions to appear at multiple portions along the rail struts, rather than at the connection points of the multiple rail struts described above (eg, multiple connection points 6064). .

  In some embodiments, as previously described, the most proximal cell structure struts 6056 and 6057 of the plurality of cell structures may be coupled to the thrombectomy device 6050 of the patient's flexure meander. For the purpose of improving the pushability of the thrombectomy device 6050 when it is advanced through the anatomical site (tortuous anatomy), Some that may be less than or equal to the maximum rail width dimension. In some embodiments, portions of the struts 6056 and 6057 that are shorter than the entire length are given a width dimension that is larger than other portions. For example, in some embodiments, the widened portion that is larger than other portions extends from the proximal end, which is the most proximal end of each of the struts 6056 and 6057, and is at the connection point 6058. It ends at a position just before the distance. The configuration of the struts 6056 and 6057 can also be changed by the several methods described above.

  With continued reference to FIG. 31, in some preferred embodiments, each of the rail portions 6060 and 6061 has a width dimension of about 0.0047 inches, and each of the rail portions 6062 and 6063 has A substantial portion of each of a plurality of strut elements having a width dimension of about 0.0036 inches and located in the remaining portion of the device (thrombosis collection device 6050); More than half) has a width dimension of about 0.0027 inches. In some other preferred embodiments, each of the rail portions 6060 and 6061 has a width dimension of about 0.0047 inches, and each of the rail portions 6062 and 6063 has a width of about 0.0036 inches. Each of the plurality of struts having dimensions and located in the distal portion 6070 (shown in phantom in the figure) of the device (thrombus collection device 6050) has a width dimension of about 0.0023 inches; Also, each of the majority of the remaining plurality of struts has a width dimension of about 0.0027 inches. The small width dimension of the distal portion 6070 creates a low radial strength region, which is a region of low radial strength, which is within the smaller diameter vessel or conduit. Reducing surface interactions between the blood vessel and the vessel or conduit, thereby damaging the vessel or conduit when the thrombectomy device 6050 is removed proximally from the patient Is prevented or reduced.

  Experiments have shown that the proximal taper region of the thrombectomy device 6050 has good force transfer characteristics, as well as good radial force characteristics. These characteristics allow the proximal taper to be inserted into the introducer sheath and / or delivery catheter and covered by them, and the resizing step, which is the re-implementation thereof, to be performed well. To.

  According to some embodiments, the thrombectomy device 6050 according to FIG. 31 laser cuts a tube having an inner diameter of about 2.130 mm and a wall thickness in the range of about 0.104 mm to about 0.128 mm. Manufactured by. In use, until the thrombectomy device 6050 according to the embodiment shown in FIG. 31 passes through the patient's tortuous vasculature or bodily duct and reaches the treatment site, It is advanced in an unexpanded or compressed state having a first nominal dimension and is in a radially expanded state from the unexpanded state to deploy a thrombectomy device 6050 at the treatment site. And can be displaced to one having a second nominal dimension greater than the first nominal dimension. In some other preferred embodiments, the second nominal dimension (eg, the average diameter of the body) is about 3.0 plus or minus 0.5 mm. In some embodiments, the dimensional and material properties of a plurality of cell structures 6080 that are generally indwelled in a body portion (Section A) of expandable material may cause the cell structures 6080, the emboli to be a patient. Selected to generate sufficient radial force and contact interaction to engage an embolus / thrombosis placed in the vessel in a manner that partially or completely removes from the vessel .

  In some embodiments, the dimensional and material properties of the elements along the expandable length of the thrombectomy device 6050 are such that the outer diameter of the thrombectomy device 6050 is constrained to 1.5 mm. , Selected to generate a radial force within a range of about 0.015 N / mm to about 0.035 N / mm per unit length. In some embodiments, the dimensional and material properties of the elements along the expandable length of the thrombectomy device 6050 are such that the outer diameter of the thrombectomy device 6050 is constrained to 1.5 mm. , Selected to generate a radial force within a range of about 0.017 N / mm to about 0.033 N / mm per unit length. In some embodiments that are the same or different from each other, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 6050 are such that the nominal diameter dimension of the body is about 2.0. When plus or minus 0.5 mm, it is selected to generate a radial force in the range from about 0.010 N / mm to about 0.020 N / mm per unit length.

In the embodiment shown in FIG. 31, many of the plurality of cell structures (except for the plurality of cell structures formed at least partially by rail segments 6051 and 6052) are the plurality of cells. The majority of the structure is shown to have a shape similar to that including a pair of short struts 6081 and a pair of long struts 6082, the short struts 6081 and a pair of long struts. 6082 are connected to each other by a connector region 6083. In some preferred embodiments (shown in FIGS. 32A-32C), each short strut 6081 has a linear length dimension L ₁ of about 0.055 plus minus 0.010 inches, and each Long strut 6082 has a linear length dimension L ₂ of about 0.128 plus or minus 0.010 inches, and connector region 6083 has a linear length of about 0.0371 plus or minus 0.010 inches. having dimensions _{L 3.} In one or more embodiments, the plurality of cell structures 6080 each have an area in the range of about 4.5 mm ² to about 5.5 mm ² . In a preferred embodiment, the cell structures 6080 each have an area of 5.0 mm ² . In some embodiments, the total length of the expandable portion of the thrombectomy device 6050 is in a range between about 25.0 mm and about 35.00 mm, and accordingly the body portion (section A) has a length in the range between about 10.0 mm and about 15.0 mm. In one desirable embodiment, the total length of the expandable portion of the thrombectomy device 6050 is about 30.7 mm, and accordingly, the body (section A) has a length of about 13.1 mm. The proximal taper and the distal taper have a length of about 10.9 mm and a length of about 6.7 mm, respectively.

Referring now to FIG. 33A, an alternative embodiment to some of the thrombectomy devices described above is shown in conjunction with FIG. 33B and 33C show a desirable three-dimensional top view and side view of the thrombectomy device 7000 shown in FIG. 33A. A plurality of sections (divided portions) of the treatment device (thrombus collection device 7000), which are generally specified as sections E and G, are those of the thrombus collection device 6000 described above. For areas that are generally the same as sections E and G, they are close to each other in many respects and are identical to each other in some circumstances. As an example, the respective width dimensions of the plurality of struts generally located in section G have different values in different embodiments, so that, as described above, the distal taper It is possible to achieve any of a plurality of desirable characteristics of the part. Section E, on the other hand, can use any of the various embodiments described above in connection with the thrombectomy device 6000 shown in FIG. As shown in FIG. 33A, the size of each of the plurality of cell structures 7002 generally located in the central section F is larger than the size in some embodiments of the thrombectomy device 6000 described above. The advantage of the low density of struts in the central section F of the thrombectomy device 7000 facilitates embolization / thrombus integration within section F of this thrombectomy device 7000. That is. In the treatment device (thrombosis collection device 7000) shown in FIGS. 33A-33C, selected ones of the plurality of long struts 6023 in the thrombectomy device 6000 are omitted, so that the size of the cell structure 6020 is reduced. A cell structure 7002 having twice the area is formed, thereby forming a plurality of cell structures larger than the cell structure of the thrombectomy device 6000. In one embodiment, the cell structures 7020 each have an area in the range of about 8.0 mm ² to about 8.5 mm ² . In one desirable embodiment, the cell structures 7020 each have an area of about 8.3 mm ² . It is important to note that any of a number of other methods can be used to form such large multiple cell structures. One advantage of the embodiment shown in FIGS. 33A-33C is the property that multiple struts are nested together to facilitate the thrombectomy device 7000 to become low profile during delivery. It means that it remains good.

A low strut density within a region generally results in a decrease in radial strength within that region. In a thrombectomy device, this reduced radial strength adversely affects the ability of the thrombectomy device to integrate with an embolus / thrombus. To compensate for this radial strength drop, in some embodiments, a plurality of optional struts 7006 (shown in dashed lines) that are generally located in section F of the thrombectomy device In addition, a width dimension larger than the width dimension of the plurality of strut portions 7004 (shown by solid lines) is given. In accordance with some embodiments, the width dimension of the strut portion 7006 is such that the overall radial strength per unit length of the expandable portion of the thrombectomy device 7000 is greater than the aforementioned, It is selected to be equivalent to the radial strength when not removing a plurality of struts to form a plurality of shaped cell structures. As an example, in some of the embodiments described above where the strut density is reduced by omitting multiple specific long struts 6023 in the thrombectomy device 6000 shown in FIG. The overall radial strength per unit length of the expandable portion of the thrombectomy device 7000 is equal to the total radial strength of the thrombectomy device 6000 described above. As selected. For example, in some embodiments, strut portion 7004 has a width dimension of about 0.0027 inches, and accordingly strut portion 7006 has a width dimension of about 0.0035 inches, thereby The overall over-all radial strength per unit length of the expandable portion of the thrombectomy device 7000, but most cell structures have a single size and the strut width The dimensions are equivalent to the total radial strength for the same area of the thrombectomy device 6000 which is approximately 0.0027 inches.

  Although not essential, as shown in FIG. 33A, it is desirable that the transition (change) of the strut width dimension occurs at a plurality of positions (indicated by “x”) excluding a plurality of connection points 7008. Although not indispensable, it is desirable that the plurality of width transition portions where the strut width transitions include a plurality of taper portions, in which the width dimension transitions relatively smoothly between portions having different width dimensions.

  The plurality of strut portions 7006 having an enlarged width dimension is one method for realizing a target value of the overall over-all radial strength per unit length. Several other approaches are also available. For example, instead, the plurality of strut portions 7006 can have a thickness dimension that is larger than the plurality of strut portions 7004, or an enlarged thickness dimension and an enlarged width dimension. It is possible to have combinations. In some other embodiments, the majority, substantially all or completely all of the width dimensions of the plurality of struts generally located in section F are to compensate for the strut density drop. Expanded to

Referring to FIG. 34A, several alternative embodiments for some of the aforementioned thrombus collection devices are shown in connection with that shown in FIG. 34B and 34C show a desirable three-dimensional top view and side view of the thrombectomy device 7020 shown in FIG. 34A. A plurality of sections (divided portions) of the treatment device (thrombus collection device) 7020, which are generally specified as sections E and G, are the thrombus collection devices 6000 described above. For areas that are generally the same as sections E and G, they are close to each other in many respects and are identical to each other in some circumstances. As an example, the respective width dimensions of the plurality of struts generally located in section G have different values in different embodiments, so that, as described above, the distal taper It is possible to achieve any of a plurality of desirable characteristics of the part. Section E, on the other hand, can use any of the various embodiments described above in connection with the thrombectomy device 6000 shown in FIG. As shown in FIG. 34A, the size of each of the plurality of cell structures 7022 generally located in the central section J is larger than the size in some embodiments of the thrombectomy device 6000 described above, thereby reducing the strut density. Having a plurality of zones, each extending in a circumferential direction, each of the zones generally divided by a plurality of rows of a plurality of cell structures 7024 that are not enlarged and extending in the circumferential direction. Is done. In the treatment device (thrombosis collection device) 7020 shown in FIGS. 34A to 34C, selected ones of the plurality of long struts 6023 in the thrombectomy device 6000 shown in FIG. 30 are omitted, so that about twice A cell structure 7022 having an area is formed, thereby forming a plurality of large cell structures. In one embodiment, the cell structures 7022 each have an area of about 8.3 mm ² . It is important to note that any of a number of other methods can be used to form such large cell structures. One advantage of the embodiment shown in FIGS. 34A-34C is the property that multiple struts are nested together to facilitate the thrombectomy device 7020 to become low profile during delivery. It means that it remains good.

As previously mentioned, lower strut density within a region generally results in lower radial strength within that region. In a thrombectomy device, this reduced radial strength adversely affects the ability of the thrombectomy device to integrate with an embolus / thrombus. In order to compensate for this radial strength drop, in some embodiments, a plurality of optional struts 7026 (shown in dashed lines) that are generally located in section J include a plurality of struts 7025. A width dimension larger than the width dimension (shown by a solid line) is given. In accordance with some embodiments, the width dimension of the strut portion 7026 is such that the overall radial strength per unit length of the expandable portion of the thrombectomy device 7020 is greater than that described above. It is selected to be equivalent to the radial strength when removal of the plurality of struts was not performed to form a plurality of shaped cell structures. As an example, in some of the embodiments described above where the strut density is reduced by omitting multiple specific long struts 6023 in the thrombectomy device 6000 shown in FIG. The overall radial strength per unit length of the expandable portion of the thrombectomy device 7020 is equivalent to the total radial strength of the thrombectomy device 6000 described above. As selected. For example, in some embodiments, strut portion 7025 has a width dimension of about 0.0027 inches, and accordingly strut portion 7026 has a width dimension of about 0.0035 inches, thereby The overall radial strength per unit length of the expandable portion of the thrombectomy device 7020, most cell structures have a single size, and the strut width The dimensions are equivalent to the total radial strength for the same area of the thrombectomy device 6000 which is approximately 0.0027 inches. In some embodiments, strut 7029 has a width dimension in the range between about 0.0031 inches and about 0.0033 inches, which is some embodiments for thrombectomy device 6000. This is equivalent to the width dimension described above in connection with.

In some embodiments, as illustrated in FIG. 34A, some or all of the plurality of strut widths each transition (change) at a plurality of positions except a plurality of connection points 7028. In some other embodiments, some or all of the plurality of strut widths each transition (change) at the location of the plurality of connection points 7028. Although not indispensable, it is desirable that the plurality of width transition portions where the strut width transitions include a plurality of taper portions, in which the width dimension transitions relatively smoothly between portions having different width dimensions.

  The plurality of strut portions 7026 having an enlarged width dimension is one method for realizing the target value of the over-all radial strength per unit length in the section J. Several other approaches are also available. For example, instead, the plurality of strut portions 7026 can have a thickness dimension that is larger than the plurality of strut portions 7025, or an enlarged thickness dimension and an enlarged width dimension. It is possible to have combinations.

Referring to FIG. 35A, another embodiment for some of the aforementioned thrombus collection devices is shown in connection with that shown in FIG. 35B and 35C show a desirable three-dimensional top view and side view of the thrombectomy device 7050 shown in FIG. 35A. A plurality of sections (divided portions) of the treatment device (thrombus collection device) 7050, which are generally specified as sections E and G, are the thrombus collection devices 6000 described above. For areas that are generally the same as sections E and G, they are close to each other in many respects and are identical to each other in some circumstances. As an example, the respective width dimensions of the plurality of struts generally located in section G have different values in different embodiments, so that, as described above, the distal taper It is possible to achieve any of a plurality of desirable characteristics of the part. Section E, on the other hand, can use any of the various embodiments described above in connection with the thrombectomy device 6000 shown in FIG. As shown in FIG. 35A, the size of each of the plurality of cell structures 7052 generally located in the central section K is larger than the size in some embodiments of the thrombectomy device 6000 described above, thereby reducing the strut density. A plurality of zones are generated, each of which is distributed among a plurality of cell structures 7054 that are not expanded. In the treatment device (thrombosis collection device) 7050 shown in FIGS. 35A to 35C, a selected one of the plurality of long struts 6023 in the thrombus collection device 6000 shown in FIG. 30 is omitted, whereby the cell structure 7054 is omitted. A cell structure 7052 having an area approximately twice the size of the cell structure 7052 is formed, thereby forming a plurality of large cell structures. In one embodiment, the cell structures 7052 each have an area of about 8.3 mm ² . In one desirable embodiment, the cell structures 7052 each have an area of about 8.3 mm ² . It is important to note that any of a number of other methods can be used to form such large cell structures. One advantage of the embodiment shown in FIGS. 35A-35C is the property that multiple struts are nested together to facilitate the thrombectomy device 7050 to become low profile during delivery. It means that it remains good.

As previously mentioned, lower strut density within a region generally results in lower radial strength within that region. In a thrombectomy device, this reduced radial strength adversely affects the ability of the thrombectomy device to integrate with an embolus / thrombus. To compensate for this radial strength drop, in some embodiments, a plurality of optional strut portions 7056 (shown in dashed lines) that are generally located in section K of the thrombectomy device. A width dimension larger than the width dimension of the plurality of strut portions 7055 (shown by solid lines) is given. In accordance with some embodiments, the width dimension of the strut portion 7056 is such that the overall radial strength per unit length of the expandable portion of the thrombectomy device 7050 is large, as previously described. It is selected to be equivalent to the radial strength when removal of the plurality of struts was not performed to form a plurality of shaped cell structures. As an example, in some embodiments described above where strut density is reduced by omitting multiple specific long struts 6023 in the thrombectomy device 6000 shown in FIG. The overall radial strength per unit length of the expandable portion of the thrombectomy device 7050 is equivalent to the total radial strength of the thrombectomy device 6000 described above. As selected. For example, in some embodiments, strut portion 7055 has a width dimension of about 0.0027 inches, and accordingly strut portion 7056 has a width dimension of about 0.0035 inches, thereby The overall over-all radial strength per unit length of the expandable portion of the thrombectomy device 7050, but most cell structures have a single size and the strut width The dimensions are equivalent to the total radial strength for the same area of the thrombectomy device 6000 which is approximately 0.0027 inches. In some embodiments, strut 7059 has a width dimension in a range between about 0.0031 inches and about 0.0033 inches, which is some embodiments for thrombectomy device 6000. This is equivalent to the width dimension described above in connection with.

  Although not essential, as shown in FIG. 35A, it is desirable that the transition (change) of the strut width dimension occurs at a plurality of positions excluding a plurality of connection points 7058. Although not indispensable, it is desirable that the plurality of width transition portions where the strut width transitions include a plurality of taper portions, in which the width dimension transitions relatively smoothly between portions having different width dimensions.

  The plurality of strut portions 7056 having an enlarged width dimension is one method for achieving a target value of the overall over-all radial strength per unit length. Several other approaches are also available. For example, instead, the plurality of strut portions 7056 can have a thickness dimension that is larger than the plurality of strut portions 7055, or an enlarged thickness dimension and an enlarged width dimension. It is possible to have combinations.

  FIG. 36 shows a thrombectomy device 6090, which is similar to that shown in FIG. 30, but with a plurality of cell structures generally located in section B of the thrombectomy device 6090. The size of 6091 is different. As shown in FIG. 36, the cell structure 6091 has a larger size than the cell structure 6020 of the thrombectomy device 6000 shown in FIG. As described above, the advantage of having a large cell structure in the main body portion of the thrombectomy device is that the thrombus is integrated with the main body portion when the radial strength of the main body portion is properly realized. To promote integration into. In order to achieve sufficient radial strength in section B of thrombectomy device 6090, a plurality of struts 6092 (shown in dashed lines) generally located in section B have an expanded width dimension. In one embodiment, the width dimension is about 0.0035 inches. In one embodiment, the width dimension of each of the plurality of struts 6092 generally located in section B is the same or equivalent to the width dimension of the distal section of rail segments 6001 and / or 6002. (For example, the same or equivalent width dimension of one or more of struts 6009, 6010 and 6011). Although not indispensable, as shown in FIG. 36, it is desirable that the transition (change) of the strut width dimension occurs at a plurality of positions excluding the plurality of connection points 6045.

  FIG. 37 shows a thrombectomy device 8000 according to some other embodiments, in which the plurality of strut elements comprising the rail segments 8001 and 8002 are particularly different from one another. It has a width dimension. FIG. 37 shows the thrombectomy device 8000 in a two-dimensional plan view, as if it had been cut and deployed flat on one surface. FIG. 37 shows the thrombectomy device 8000 in its manufactured state (as-cut, cut for deployment and flattened). In one embodiment, the rail segment 8001 is located at the same position as or near its distal end 8015 from its maximum width dimension at or near its proximal end 8014. Vary to the minimum width dimension at. Similarly, a rail segment 8002 has a maximum width dimension at the same location as or near its proximal end 8014, and from the maximum width dimension at or near its distal end 8016. Changes to narrow dimensions. As described above, the respective width dimensions of the rail segments 8001 and 8002 distribute the force when a push force acts on the proximal end 8014 of the thrombectomy device 8000. Along with the ability to withstand buckling. In some embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is between about 20.0% and about 35.0%. % Is between. In some other embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is between about 25.0% and about 30%. It is between 0.0%. In one preferred embodiment, each of the rail segments 8001 and 8002 has a width dimension of about 0.0027 plus or minus 0.0004 inches to a maximum width dimension of about 0.0027 plus or minus 0.0004 inches. Changes to narrow dimensions. In another preferred embodiment, each of the rail segments 8001 and 8002 has a width dimension of about 0.0034 plus or minus 0.0004 inches from a maximum width dimension of about 0.0047 plus or minus 0.0004 inches. Changes to the minimum width dimension.

  As described earlier in this specification, FIG. 37 shows a plurality of rail segments 8001 and 8002 that do not have a corrugated portion, but rail segments as shown in FIGS. 1A and 4A are also applicable to this embodiment. It is understood that it is a target. Further, similar to the thrombectomy device 6000 shown in FIG. 30, the rail width dimension characteristics described above, apart from those described above, a plurality of previously disclosed herein in connection with FIGS. Any number of features and / or characteristics of a vascular treatment device (thrombosis collection device) (eg, dimensions, spatial, relational, etc.) Can be incorporated into a thrombectomy device 8000 according to FIG.

  In some embodiments, the width dimension of each of the rails 8001 and 8002 decreases at a substantially constant rate along the respective total length (or a portion of the total length). and diminishing fashion). In some embodiments, each of a plurality of discrete rail portions of each of rails 8001 and 80022 has a substantially uniform width dimension, while these rail portions have a width dimension. In order to connect different ones to each other, a plurality of transitional tapers (transitional tapers, parts having a gradually changing width dimension interposed between rail portions) are used. In some embodiments, each of the plurality of rail portions 8001 and 8002 that are discrete from each other individually has a substantially uniform width dimension, while the rail portions are: A plurality of stepped transitions (parts whose width dimension changes stepwise by being interposed between rail parts) are used in order to couple those having different width dimensions to each other. In some other embodiments, two or more of the above-described methods of transitioning width dimensions are utilized. Although not indispensable, it is desirable that the transition portions appear at a plurality of portions along the struts, not at the connection points of the plurality of struts described above (for example, the plurality of connection points 8030).

  In some embodiments, as described above, the struts 8012 and 8013 of the most proximal cell structure 8018 located closest to the plurality of cell structures are connected to the bend of the thrombectomy device 8000 of the patient. For the purpose of improving the pushability of the thrombectomy device 8000 when it is advanced in a tortuous anatomy, it is a width dimension expanded from other parts, Some of them may be less than or equal to the maximum rail width dimension. In some embodiments, portions of the struts 8012 and 8013 that are shorter than the entire length are given a width dimension that is larger than other portions. For example, in some embodiments, the widened portion that is larger than the other portion extends from the most proximal end of each of the struts 8012 and 8013, and the struts 8012 and 8013. It ends at a position in front of a certain distance from the connecting point. The configuration of the struts 8012 and 8013 can also be changed by some of the methods described above.

  With continued reference to FIG. 37, in some preferred embodiments, all or part of struts 8003 and 8004 (optionally, but also all or part of struts 8005 and 8006 are added). Each has a width dimension in the range of about 0.0045 inches to about 0.0050 inches, and all or part of struts 8007 and 8008 (optionally, all or part of struts 8005 and 8006 Each with a width dimension in the range of about 0.0036 inches to about 0.0040 inches, and all or part of struts 8009 and 8010 (although optionally , Each or all of struts 8007 and 8008 are also added) Having a width in the range of blood of about 0.0036 inches. In some embodiments, each of the remaining of the plurality of strut elements generally located in section M of the device (thrombectomy device 8000) has a width dimension of about 0.0027 inches; Also, each of the plurality of strut elements generally located in section N has a width dimension within the range of about 0.0034 inches to about 0.0036 inches, and the plurality of strut elements generally located in section O. Each of the elements has a width dimension in the range of about 0.0031 inches to about 0.0033 inches. In one or more of the several embodiments just described, the respective width dimension of struts 8012 and 8013 is between about 0.0036 inches and about 0.0047 inches. It should be understood that the dimensions disclosed throughout this specification relate to some preferred embodiments and may depend on conventional manufacturing dimensional tolerances. There may be multiple variations on these dimensions, which are contemprated by this embodiment.

  Although not indispensable, multiple transitions where the strut width transitions appear at multiple portions along the struts, rather than at the aforementioned multiple strut connection points (eg, multiple connection points 8030 and 8032). It is desirable.

As shown in FIG. 37, the strut density in the region specified entirely by “N” is greater than the strut density in the region specified entirely by “M” and the region specified entirely by “O”. , Especially low. As a result, the plurality of cell structures 8020 generally located in section N have a larger size than the plurality of cell structures 8021 generally located in sections M and O. As described above, the advantage of the presence of the large cell structure in the main body of the thrombectomy device 8000 is that when the radial strength of the main body is properly realized, It promotes integration into (section N). In order to achieve sufficient radial strength in section N of thrombectomy device 8000, the plurality of struts located in section N is composed of a plurality of cell structures generally located in section M (struts 8003-8013). And a plurality of cell structures generally located in section O have an expanded width dimension. In one embodiment, the width dimension of each of the plurality of struts located in section N is the same as the width dimension of the distal struts 8009, 8010 and / or 8011 of the rail segments 8001 and / or 8002. Or equivalent.

  In a preferred embodiment, each of the struts 8003-8006 has a width dimension of about 0.0047 inches and each of the struts 8007 and 8008 and the proximal portion of the strut 8010 is about 0.0040. Each having a width dimension of inches, each of struts 8009 and 8011 and the distal portion of strut 8010 having a width dimension of about 0.0034 inches, and each of struts 8012-8013 having a width dimension of about 0.0034 inches. It has a width dimension of 0.0040 inches. In some embodiments, each of the remaining plurality of struts located in section M of the device (thrombus collection device 8000) has a width dimension of about 0.0027 inches, and Each of the plurality of struts located in section N has a width dimension of about 0.0034 inches, and each of the plurality of struts located in section O has a width dimension of about 0.0031 inches. . Advantageously, the increased width dimension of the plurality of struts in section O allows the distal taper of the thrombectomy device 8000 to be delivered while the thrombectomy device 8000 is delivered to the patient's treatment site. The possibility of buckling of the struts in the (distal taper region) is reduced. The enlarged width dimension further provides a radial strength of the proximal taper that opens the distal taper while the thrombectomy device 8000 is withdrawn from the patient. The ability to be retained is increased, thereby allowing the thrombectomy device 8000 to sweep away the remaining portion of the embolus.

  According to some embodiments, a thrombectomy device 8000 according to FIG. 37 laser cuts a tube having an inner diameter of about 3.77 mm and a wall thickness in the range of about 0.097 mm to about 0.131 mm. Manufactured by. In use, until the thrombectomy device 8000 according to the embodiment shown in FIG. 37 passes through the patient's tortuous vascular anatomy or bodily duct to reach the treatment site, It is advanced in an unexpanded or compressed state having a first nominal dimension and is in a radially expanded state from the unexpanded state to deploy a thrombectomy device 8000 at the treatment site. And having a second nominal dimension greater than the first nominal dimension. In some other preferred embodiments, the second nominal dimension (eg, the average diameter of the body portion) is about 5.5 plus or minus 0.5 mm. In some embodiments, the dimensional and material properties of a plurality of cell structures 8020 that are generally indwelled within the body (section N) may cause the cell structures 8020 to be partially or from the patient with the embolus. It is selected to generate a radial force and contact interaction sufficient to engage an embolus / thrombus that is indwelled in the vessel in a manner that is completely removed.

  In some embodiments, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 8000 are such that the outer diameter of the thrombectomy device 8000 is constrained to 1.5 mm. , Selected to generate a radial force within a range of about 0.040 N / mm to about 0.065 N / mm per unit length. In some embodiments, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 8000 are such that the outer diameter of the thrombectomy device 8000 is constrained to 1.5 mm. , Selected to generate a radial force within a range from about 0.045 N / mm to about 0.060 N / mm per unit length. In some embodiments, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 8000 are such that the outer diameter of the thrombectomy device 8000 is constrained to 1.5 mm. , Selected to generate a radial force within a range of about 0.050 N / mm to about 0.060 N / mm per unit length. In some embodiments, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 8000 are such that the outer diameter of the thrombectomy device 8000 is constrained to 1.5 mm. , Selected to generate a radial force within a range of about 0.049 N / mm to about 0.057 N / mm per unit length. In some embodiments, the same or different from each other, the dimensional and material properties of the elements along the expandable length of the thrombectomy device 8000 are such that the nominal diameter dimension of the body is about 4.5. When plus or minus 0.5 mm, it is selected to generate a radial force in the range from about 0.010 N / mm to about 0.020 N / mm per unit length.

In some embodiments shown in FIG. 37, the plurality of cell structures located in sections M and O (including a plurality of cell structures formed at least partially by rail segments 8001 and 8002). Are shown in terms of shape to be similar to a plurality of cell structures 8021 having a pair of short struts 8022 and a pair of long struts 8024. In some desirable embodiments, the area of the cell structure 8021 is in the range of about 4.5 mm ² and about 5.5 mm ² . In one embodiment, the cell structure 8020 generally located in section N has a shape constituted by two cell structures 8021 adjacent to each other, and accordingly, between the two cell structures 8021, Long struts 8024 are omitted. Although it is possible to consider other types of large cell structures as application targets of the present embodiment, the advantage of the cell configuration mode shown in FIG. 37 is that the cell configuration mode is the thrombectomy device 8000. In order to be able to become low profile during delivery, the struts possess good nesting characteristics with each other.

  In some preferred embodiments, the total length of the expandable portion of the thrombectomy device 8000 is in the range between about 55.0 mm and about 65.00 mm, and accordingly the body portion ( Section N) has a length in the range between about 25 mm and about 35.0 mm, and the proximal taper and the distal taper are about 10.0 mm and about 20 mm, respectively. It has a length in the range between 0 mm. In one desirable embodiment, the total length of the expandable portion of the thrombectomy device 8000 is about 58.4 mm, and accordingly the body (section N) has a length of about 29.3 mm. The proximal taper and the distal taper have a length of about 16.6 mm and a length of about 12.5 mm, respectively.

FIG. 38 illustrates a thrombectomy device 8050 according to some other embodiments, in which the plurality of strut elements comprising rail segments 8051 and 8052 are each different from one another. It has a width dimension. FIG. 38 shows the thrombectomy device 8050 in a two-dimensional planar development as if it had been cut and deployed flat on one surface. FIG. 38 shows the thrombectomy device 8050 as it is manufactured (as-cut, cut for deployment and flattened). In one embodiment, the rail segment 8051 is located at the same position as or near its distal end 8067 from its maximum width dimension at or near its proximal end 8066. Vary to the minimum width dimension at. Similarly, a rail segment 8052 has a maximum width dimension at or near its proximal end 8066 and from its maximum width dimension at or near its distal end 8068. Changes to narrow dimensions. As described above, the respective width dimensions of the rail segments 8051 and 8052 distribute the force when a push force acts on the proximal end 8066 of the thrombectomy device 8050. Along with the ability to withstand buckling. In some embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is between about 20.0% and about 35.0%. % Is between. In some other embodiments, the percentage change between the maximum rail width dimension and the minimum rail width dimension is about 22.0% and about 27 It is between 0.0%. In a preferred embodiment, each of the rail segments 8051 and 8051 has a width dimension of about 0.0047 plus or minus 0.0004 inches to a maximum width of about 0.0035 plus or minus 0.0004 inches. Changes to narrow dimensions.

  As described above in this specification, FIG. 38 shows a plurality of rail segments 8051 and 8052 having no corrugations, but rail segments as shown in FIGS. 1A and 4A are also applicable to this embodiment. It is understood that it is a target. Further, similar to the thrombectomy device 6000 shown in FIG. 30, the rail width dimension characteristics described above, apart from those described above, a plurality of previously disclosed herein in connection with FIGS. Any number of features and / or characteristics of a vascular treatment device (thrombosis collection device) (eg, dimensions, spatial, relational, etc.) Can be incorporated into a thrombectomy device 8050 according to FIG.

  In some embodiments, the width dimension of each of rails 8051 and / or 8052 decreases along a respective full length (or a portion of the full length) at a substantially constant rate of reduction ( It is tapered in substantial uniform and diminishing fashion. In some embodiments, each of the rails 8051 and 80522, each of the plurality of discrete rail portions having a substantially uniform width dimension, is the rail portion having a width dimension. In order to connect different ones to each other, a plurality of transitional tapers (transitional tapers, parts having a gradually changing width dimension interposed between rail portions) are used. In some embodiments, each of the plurality of rail portions 8051 and 8052 that are discrete from each other individually has a substantially uniform width dimension, while the rail portions are: A plurality of stepped transitions (parts whose width dimension changes stepwise by being interposed between rail parts) are used in order to couple those having different width dimensions to each other. In some other embodiments, two or more of the above-described methods of transitioning width dimensions are utilized. Although not indispensable, the transitions are not at the rail connection points (e.g., the connection points 8070) described above, but in portions along the rail struts (rails 8051 and / or 8052). It is desirable to appear in

  In some embodiments, as described above, the most proximal struts 8064 and 8065 of the most proximal cell structures of the plurality of cell structures may be coupled to the tortuous flexure of the thrombectomy device 8050 of the patient. For the purpose of improving the pushability of the thrombectomy device 8050 when it is advanced in the tortuous anatomy, the width dimension being larger than other parts, Some that may be less than or equal to the maximum rail width dimension. In some embodiments, the portion of the struts 8064 and 8065 that are shorter than the entire length is given a width dimension that is larger than other portions. For example, in some embodiments, an expanded width portion that is larger than other portions extends from the most proximal end of each of struts 8064 and 8065, which is the most proximal end, It ends at a position a short distance from the connection point of the struts 8064 and 8065. The configuration of the struts 8064 and 8065 can also be changed by some of the methods described above.

  With continued reference to FIG. 38, in some preferred embodiments, all or part of struts 8053 and 8054 (optionally, but also all or part of struts 8055 and 8056 are added). Each has a width dimension in the range of about 0.0045 inches to about 0.0050 inches, and all or part of struts 8057 and 8058 (optionally but struts 8055, 8056, 8059 and Each of which is added in whole or part of 8060) and has a width dimension in the range of about 0.0036 inches to about 0.0040 inches, and all or part of struts 8059 and 8060 (optional) (Although all or part of struts 8061, 8062 and 8063 are also added) Each having a width in the range of about 0.0034 inches to about 0.0036 inches. In some embodiments, each of the remaining of the plurality of struts generally located in section P of the device (thrombosis collection device 8050) has a width dimension of about 0.0027 inches, and Each of the plurality of struts generally located in section Q has a width dimension within the range of about 0.0034 inches to about 0.0036 inches, and each of the plurality of struts generally located in section R is about It has a width dimension in the range of 0.0031 inches to about 0.0033 inches. In one or more of the several embodiments just described, the respective width dimension of struts 8064 and 8065 is between about 0.0036 inches and about 0.0047 inches. It should be understood that the dimensions disclosed throughout this specification relate to some preferred embodiments and may depend on conventional manufacturing dimensional tolerances. There may be multiple variations on these dimensions, which are contemprated by this embodiment.

  Although not indispensable, a plurality of transition portions where the strut width transitions appear in a plurality of portions along the struts, not in the connection points of the plurality of rails described above (for example, the connection points 8070 and 8071). It is desirable.

  As shown in FIG. 38, the strut density in the region specified by “Q” is larger than the strut density in the region specified by “P” and the region specified by “R”. , Especially low. As a result, the plurality of cell structures 8080 generally located in section Q have a larger size than the plurality of cell structures 8081 generally located in sections P and R. As described above, the advantage of the presence of the large cell structure in the main body portion of the thrombectomy device 8050 is that when the radial strength of the main body portion is properly realized, the thrombus is in the main body portion. It is to promote integration into (section Q). For the purpose of achieving sufficient radial strength in section Q of thrombectomy device 8050, the plurality of struts generally located in section Q has a plurality of cell structures generally located in section P (struts 8053- (Excluding 8065) and a plurality of cell structures generally located in section R have an expanded width dimension. In one embodiment, the width dimension of each of the plurality of struts located in section Q is equal to the width dimension of the distal section (eg, struts 8061, 8062 and / or 8063) of each of the rails 8051 and 8052. Are the same or equivalent.

In one desirable embodiment, the struts 8053 - each and 8054, each of the proximal portion of the struts 8055 and 8056 has a width dimension of about 0.0047 inches, and the respective struts 8057 and 8058, each The distal portion of struts 8055, 8056 and the proximal portion of each strut 8059, 8060 each have a width dimension of about 0.0040 inches, and each of struts 8061 , 8062 , 8063, The distal portions of struts 8059 and 8060 each have a width dimension of about 0.0035 inches. In some embodiments, each of the remaining of the plurality of struts generally located in section P of the device (thrombus collection device 8050) has a width dimension of about 0.0027 inches, and , Each of the plurality of struts generally located in section Q has a width dimension of about 0.0035 inches, and each of the plurality of struts generally located in section R is about 0.0031 inches wide Have dimensions. Advantageously, the increased width dimension of the plurality of struts in section R allows the distal taper of the thrombectomy device 8050 to be delivered while the thrombectomy device 8050 is delivered to the patient's treatment site. The possibility of buckling of the struts in the (distal taper region) is reduced. The enlarged width dimension further provides a radial strength of the proximal taper that opens the distal taper while the thrombectomy device 8050 is withdrawn from the patient. The ability to be held in the increased state is increased, thereby allowing the thrombectomy device 8050 to sweep away the remaining portion of the embolus.

  According to some embodiments, the thrombectomy device 8050 according to FIG. 38 laser cuts a tube having an inner diameter of about 3.77 mm and a wall thickness in the range of about 0.097 mm to about 0.131 mm. Manufactured by. In use, until the thrombectomy device 8050 according to the embodiment shown in FIG. 38 passes through the patient's tortuous vascular anatomy or bodily duct to reach the treatment site, It is advanced in an unexpanded or compressed state having a first nominal dimension and is in a radially expanded state from the unexpanded state to deploy a thrombectomy device 8050 at the treatment site. And can be displaced to one having a second nominal dimension greater than the first nominal dimension. In some other preferred embodiments, the second nominal dimension (eg, the average diameter of the body) is about 6.0 plus or minus 0.5 mm. In some embodiments, the dimensional and material properties of the plurality of cell structures 8080 that are placed in the body (section Q) may cause the cell structures 8080 to be partially or completely emboli from the patient. Selected to generate a radial force and contact interaction sufficient to engage an embolus / thrombosis placed in the vessel. In some embodiments, the dimensional and material properties of the plurality of elements along the expandable length of the thrombectomy device 8050 are such that the body diameter is about 5.0 plus or minus 0.5 mm. When reduced, it is selected to generate a radial force that is in the range of about 0.010 N / mm to about 0.020 N / mm per unit length.

In the embodiment shown in FIG. 38, the plurality of cell structures generally located in sections P and R (excluding the plurality of cell structures formed at least in part by rail segments 8051 and 8052) ) Is shown to be similar in shape to a plurality of cell structures 8081 having a pair of short struts 8082 and a pair of long struts 8084. In a preferred embodiment, the area of the cell structure 8081 is about 9.2 mm ² . In one embodiment, the cell structure 8080 generally located in section Q has a shape constituted by two cell structures 8081 adjacent to each other, and accordingly, between the two cell structures 8081, Long struts 8084 are omitted. Although a plurality of large cell structures of other types can be considered as an application target of the present embodiment, the advantage of the cell configuration mode shown in FIG. In order to be able to become low profile during delivery, the struts possess good nesting characteristics with each other.

  In some embodiments, the total length of the expandable portion of the thrombectomy device 8050 is in a range between about 65.0 mm and about 75.00 mm, and accordingly, the body portion (section Q) has a length in the range between about 25.0 mm and about 35.0 mm. In one desirable embodiment, the total length of the expandable portion of the thrombectomy device 8050 is about 71.9 mm, and accordingly the body (section Q) has a length of about 32.3 mm. And the proximal taper and the distal taper have a length of about 22.5 mm and a length of about 17.1 mm, respectively.

  FIG. 39 shows a two-dimensional view of a conduit embolus retrieval device 370 according to another embodiment. Similar to some other embodiments described above, the retrieval device 370 has a proximal tapered end 371, a tubular body 372, and a distal tapered end 373. The distal tapered end 373 has a different point from the previously described distal tapered end, which is that the distal tapered end 373 defines the length dimension of the distal tapered end 373. For the sake of shortening, it is a complete cell row of 3 rows, and all cell structures belonging to it have a structure smaller than three full rows. In the example of FIG. 39, the distal tapered end 373 has two rows of full cell structures 374 and 375 (a row 374 of complete cell structures and a complete cell structure). , And a partial cell structure row (partial row) 376 for one row in which partial cell structures (those in which a part of the complete cell structure is missing) are arranged. (For clarity of explanation, in the embodiment of FIG. 39, column 375 has only one cell structure, but in any case is considered to be a column of multiple cell structures.) The retrieval device 370 has a distal taper end 373 with its apex leading to the distal antenna 379, which makes it impossible for a retrieval device to have a rounded end. The benefits of One advantage is that once the retrieval device 370 is placed and expanded in the patient's blood vessel, the tapered end (distal tapered end 373) has a rounded end. A higher degree of placement than the collection device. Another advantage is that the distal tapered end 373 is better atraumatic than a blunt end. By shortening the structure of the distal tapered end 373 to a structure smaller than the full cell structure row for three rows, the taper length is shortened, and as a result, more stable than the case having a larger number of cell structure rows. An advantage was obtained in that a distal taper (distal taper end 373) having good resistance and atraumatic property was obtained. In a retrieval tool having a plurality of cell structures of different sizes, a complete cell structure row corresponding to the aforementioned plurality of rows at the distal tapered end 373 is similar to that of the cell structures 376 and 377. Like FIG. 39, it is desirable that a plurality of cell structures 377, substantially all of which are small in size, be configured.

  According to some embodiments, the length of the distal tapered end 373 in an as-cut manufactured state, a state where the cut is made for deployment and flattened after production. The dimension is shorter than the dimension of about 30% of the length dimension of the main body part 372, and desirably is shorter than the dimension of about 25% of the length dimension of the main body part 372. In one embodiment, the length dimension of the body portion 372 and the length dimension of the distal tapered end 373 are about 26 mm and about 6 mm, respectively. In another embodiment, the distal tapered end 373 has a length dimension in the range between about 4.5 mm and about 5.0 mm. According to some embodiments, the combined length of the length dimension of the distal tapered end 373 and the length dimension of the distal antenna 379 is less than about 10 mm.

  FIG. 40A shows a two-dimensional view of a conduit embolus retrieval device 380 according to another embodiment. Similar to the retrieval device 370 shown in FIG. 39, the retrieval device 380 has a distal tapered end that has a structure smaller than three rows of full cell structures. The retrieval device 380 has a plurality of cell structures whose distal taper ends branch into a first cell structure set 386 and a second cell structure set 387, and accordingly The retrieval device 370 in that the termination of one cell structure set 386 is located at the first distal antenna 388 while the termination of the second cell structure set 387 is located at the second distal antenna 389. Is different. FIG. 40B shows a three-dimensional view of the retrieval device 380, in which the reference numeral 383 indicates the distal tapered end of the retrieval device 380. FIG. As shown in FIG. 40B, distal antenna 388 and distal antenna 389 have a distal tapered end 383 that is coupled together to have a closed end. A collection device 380 is formed.

  It is important to note that while the retrieval devices 370 and 380 have been described above as having distal antennas, in some other embodiments, similar retrieval devices have distal antennas. It is provided without. The same applies to each of the several embodiments described above and considered herein. On the other hand, with respect to the retrieval device 380 shown in FIG. 40, in another embodiment, a single distal antenna, selected to be located between the distal antenna 388 and the distal antenna 389. Is provided. In this type of embodiment, the retrieval device 380 will have an open distal end, which is associated with the second cell structure. The set 387 can be used to sweep along the vessel that is the treatment site to capture the scattered material.

  FIG. 41 shows a two-dimensional view of a conduit embolization retrieval device 390 according to another embodiment, the retrieval device 390 having a proximal tapered end, and three rows of complete cell structures. Have a structure smaller than the column. Similar to the retrieval device 380, the distal tapered end of the retrieval device 390 has a plurality of cell structures branched into a first cell structure set 396 and a second cell structure set 397. Accordingly, the end of the first cell structure set 396 is located at the first distal antenna 398, while the end of the second cell structure set 397 is located at the second distal antenna 399. As shown in FIG. 41, the first and second distal antennas 398 and 399 have offset structures that are shifted from each other in the longitudinal (major axis) direction. In one embodiment, radiopaque material, features (eg, flared struts) or components (eg, coils) are disposed on the first and second distal antennas 398 and 399, respectively. Thanks to its offset structure, the location (contour) of the distal end of this retrieval device 390 is achieved by radiopaque material, eg, one disposed on each of the first and second distal antennas 398 and 399. ) And the position (contour) of the distal tapered end of this retrieval device 390 is visualized during treatment.

  FIG. 42A shows a two-dimensional view (two-dimensional development) of a conduit embolus retrieval device 450 according to another embodiment. The retrieval device 450 has a self-expanding member that has a proximal tapered end 451, a tubular body 452, and a distal tapered end 453. The proximal most proximal cell structures at the proximal tapered end 451 have a plurality of outer wall segments, the outer wall segments including a first rail segment 454 and a second rail segment. A rail segment 455 is formed. Each of the rail segments 454 and 455 extends from the most proximal end, which is the most proximal end of the self-expanding member, to the same position as or the vicinity of the proximal end of the tubular body 452. Yes. In the embodiment shown in FIG. 42, each of the rail segments 454 and 455 has a corrugated portion. A proximal antenna 457 extends proximally from the proximal cell structure 456.

  As shown in more detail in FIG. 42B, the proximal cell structure 456 includes a first outer strut 460 and a second outer strut 461, respectively, and a first inner strut 462 and a second inner strut 463, respectively. Have 42B, the first outer strut 460 and the first portion 461a of the second outer strut 461 are shown in the two dimensional layout. While extending linearly, the first inner strut 462, the second inner strut 463, and the second portion 461b of the first outer strut 461 extend in a curved manner in the two-dimensional development view. ing. In the three-dimensional state after manufacture, the first outer strut 460 and the first portion 461a of the second outer strut 461 are curved and have no corrugated portion. The plurality of straight strut segments described above of the proximal cell structure 456 are oriented toward the proximal end of the self-expanding member and together with the proximal antenna 457 (coextensive, in parallel). As a result of the extension, the pushability of the retrieval device 450 when it is delivered to pass through the anatomical site of the patient has recently only had a curved strut in the two-dimensional development. It is improved from the collection device having the unit cell structure.

  In some embodiments, the total length of struts 460 and 462 (L1) and the total length of struts 461 and 463 (L2) are substantially the same, the purpose of which is the self-expanding member The purpose of this is to promote the nesting of the struts when they change from an expanded state to a non-expanded state. According to some embodiments, the difference between the total lengths L1 and L2 is less than 5.0%, but in some other embodiments, the difference between the total lengths L1 and L2 is 1.0%. %Fewer.

  FIG. 43 shows a modification of the nearest cell structure 456. As shown, each of the struts 460 and 461 has a narrow portion 464 and 465 that is narrow, and the narrow portions 464 and 465 are connected to the narrow portion 464 and 465 and the proximal antenna 457. It is located at a position adjacent to the point 466. Having narrow portions 464 and 465 collapses the proximal cell structure 456 by reducing the force required to initiate and perform collapse of the proximal cell structure 456. (Collapse) Ability (easiness to collapse) can be improved locally. Thus, for example, the retrieval device 450 may be initially introduced into the introducer sheath for placement within the delivery catheter, or within the delivery catheter after the self-expanding member has been deployed within the patient's body. , The narrow portions 464 and 465 cause the struts 460 and 461 in the area of the connection point 466 to have a narrow portion 464 with less force than is required without the narrow portions 464 and 465. And 465 are easier to fold than without. This facilitates handling of the retrieval device 450 when it is handled by a caregiver when the retrieval device 450 is first being introduced into the delivery catheter, thereby allowing the retrieval device 450 to be handled. The possibility of being damaged during the introduction process is reduced. As described above, after the retrieval device 450 has been introduced into the delivery catheter and the retrieval device 450 has been expanded within the patient's conduit, There may be several occasions where the patient is pulled back (proximally, in the direction approaching the delivery catheter) and inserted into the delivery catheter. This may occur, for example, after the retrieval device 450 has been improperly placed in the conduit or after the procedure for retrieval has been completed. In each of these instances, several advantages are realized because the force required to collapse the self-expanding member of the retrieval device 450 is small. One advantage is that this allows the retrieval device 450 to act on the delivery catheter in such a way as to inadvertently displace the delivery catheter within the patient's conduit. Is alleviated. Another advantage is that it reduces the possibility of excessive forces acting on the attachment between the proximal antenna 457 and the longitudinal wire (eg, the longitudinal flexible wire 40 shown in FIG. 1A). Such excessive force will cause damage at the connection point.

  In the embodiment shown in FIG. 43, the narrow portions 464 and 465 each have a tapered portion. In some other embodiments, the narrow portions 464 and 465 are each represented by a strut width stepwise decrease where the strut width decreases stepwise. The amount of reduction in the width dimension at each of the narrow portions 464 and 465 will vary according to the respective nominal width dimension of the struts 460 and 461. In any case, it is important to note that the amount of width reduction depends on the radial force requirements and structural integrity (structural integrity, structural safety, structural integrity, structural integrity) of the self-expanding member. Is consistent (consistent). The amount of reduction in the width dimension in the post-manufacturing state (as-cut manufactured state) is about 5.0% and about 20.0%. Is suitable for a plurality of struts having a nominal width dimension in the range between about 0.0057 inches to about 0.0027 inches, at which time the width dimension is reduced. It has been found desirable to be in a range between about 10.0% and about 20.0%. In one embodiment, the width dimension W1 of each of the struts 460 and 461 is about 0.0053 inches, and accordingly, the minimum width dimension of each of the narrow portions 464 and 465 is about 0.0047 inches. In another embodiment, the width dimension W1 of each of the struts 460 and 461 is about 0.0057 inches, and accordingly, the minimum width dimension of the narrow portion is about 0.0046 inches.

  In some embodiments, each of the struts 460 and 461 is inconsistent with each other as-cut width dimension (width dimension when cut for deployment to form a flat surface). Accordingly, the width dimensions of the narrow portions 464 and 465 are also inconsistent with each other. For example, in one embodiment, strut 460 has a width dimension of about 0.0050 inches, strut 461 has a width dimension of about 0.0057 inches, and narrow portions 464 and 465. Each have a width dimension of about 0.0042 inches and a width dimension of about 0.0046 inches.

  FIG. 44 shows another variation of the proximal cell structure 457 in which the outer struts 460 and 461 are respectively connected to the proximal section 467, the central section 468, and the distal section. Position section 469. For the purpose of improving the easiness of the self-expanding member, the width of each of the outer struts 460 and 461 of the proximal cell structure 457 is a plurality of the remaining devices positioned in the remaining portion. Are generally constructed to be larger than most of the struts of the material, because of the bulk of material at the connection points 471 and 472 located at the distal ends of the struts 460 and 461. However, it may impair the ability of the self-expanding member to collapse (ability to collapse, ease of collapsing, folding, stretchability, and collapse). Thus, in the embodiment shown in FIG. 44, the distal section 469 has a narrow portion, the purpose of which is to reduce the amount of material occupying the region of the connection points 471 and 472. FIG. 44 also shows a proximal section 467 having a narrow portion (similar to that described above), but in some embodiments this is different. In the manner described above, a section having a narrow portion may have a tapered portion and / or a stepped portion.

  Another advantage of the embodiment shown in FIG. 44 is that the central section 468 of each of the struts 460 and 461 has a width dimension sufficient to improve the visibility of the retrieval device under fluoroscopy. That is, the improved visibility is achieved without significantly affecting the ability of the proximal end of the proximal taper 451 to collapse or otherwise exhibit an unexpanded state. According to one embodiment, the width dimension of the central section 468 in the strut is about 0.0053 inches, and the minimum width dimension of the proximal section 467 and the minimum width dimension of the distal section 469 are each about 0.0047. Inches and about 0.0041 inches. As in some of the several embodiments shown in FIG. 43, in the embodiment shown in FIG. 44, the width dimensions of each of the struts 460 and 461 are inconsistent with each other, and accordingly the proximal One or more of the width dimensions of section 467, central section 468, and distal section 469 are inconsistent with one another.

  FIG. 45A is a two-dimensional view of a conduit embolus retrieval device 800 according to another embodiment. The retrieval device 800 has a self-expanding member that has a proximal tapered end 801, a tubular body 802, and a distal tapered end 803. The outermost cell structures located on the outermost side within the proximal tapered end 801 have a plurality of outer wall segments, which on one side are non-wave-like rail segments ( Rail) 804, while on the other side, a wavy rail segment 805 (rail) is formed. Each of the rail segments 804 and 805 extends from the most proximal end of the self-expanding member to the same position as the proximal end of the tubular body 802 or a position near it. Proximal antenna 806 extends proximally from the most proximal proximal proximal cell structure 807, while distal antenna 807 is out of distal tapered end 803. It extends in a distal direction (distally away from the operator) from the distal end of the device. The distal tapered end 803 is similar to that described in connection with FIG. In some embodiments, the nearest cell structure 807 has the same features and characteristics as the nearest cell structure 456 in some embodiments shown in FIGS. 42-44 above.

  As a result of the plurality of cell structures being arranged diagonally in the recovery device 800, the lengths of the straight lines that the rails 804 and 805 pass through are as-cut manufactured state (post-manufactured state). In a state in which cutting is performed for deployment to form a planar shape), the straight lines through which the rail 804 passes are longer than the straight lines through which the rail 805 passes. The linear configuration of the rails 804 provides an advantage in combination with the wavy configuration of the rails 805, and the advantages are that each of the rails 804 and 805, respectively, when the retrieval device 800 exhibits an unexpanded / feeding state. The lengths of the two are closer together. According to one embodiment, the rails 804 and 805 are each configured to achieve a length that substantially matches each other when the retrieval device 800 exhibits an unexpanded / delivered state. In some embodiments, the difference in length between the rails 804 and 805 is within a range between about 0% and about 5% when the retrieval device 800 exhibits an unexpanded / delivered state. It is in.

  As mentioned above, some collection devices disclosed and considered herein are generally manufactured by cutting a tube with a laser, and the collection devices are actually three-dimensional configurations. In general, it has a structure resembling a tube. Like many of the other drawings, FIG. 45 shows a collection device deployed in a two-dimensional planar state, ie, cut along itself along its length and deployed in one plane. As shown. Based on this assumption, referring to FIG. 45B, in the two-dimensional development state, the plurality of cell structures are a plurality of polygons having a plurality of struts. As shown, rail segments 804 and 805 are defined by the respective outer walls of outermost cell structures 807, 810, and 811 within proximal tapered end 810. A wavy rail segment 805 is formed by a first outer wall 812 of the proximal cell structure 807 and a plurality of outer walls 814 of the plurality of outer cell structures 810, whereas a non-wavy rail A segment 804 is formed by the second outer wall 813 of the nearest cell structure 807 and the plurality of outer walls 815 of the plurality of outer cell structures 811. As shown in FIG. 45B, in the two-dimensional development state, the outer wall 814 is curved while the outer wall 815 is linear. As will be appreciated, when taking the form of a tube, when the self-expanding member is in the expanded state, the rail 804 is curved, but nevertheless does not have a corrugated portion. . The rail 805, when in its three-dimensional state, is also curved and has a degree of curvature, but unlike the rail 804, it has a wavy portion.

  The advantage of adopting the design of proximal tapered end 801 is that the non-wavy rail segment 804 has some of the aforementioned effects related to thrust and kink resistance, while the wavy rail segment. 805 is that the proximal tapered end 801 allows a plurality of polygons that are symmetrical in shape and / or a plurality of polygons that are close in shape to symmetry. At the proximal taper end 801, the greater the number of polygons and / or near-symmetrical polygons than the shape is symmetric, the greater the ability of the proximal taper end 801 to exhibit an unexpanded or compressed state. In addition, the structural uniformity and compactness of the proximal tapered end 801 is improved. Some of the effects described above are symmetrical in shape because cell structures that are symmetrical in shape are more likely to be nested than cell structures that are symmetrical in shape. This is accomplished at least in part by placing a greater number of cell structures within the proximal tapered end 801.

  Another advantage of having proximal tapered end 801 having one non-wave rail segment 804 and one wave rail segment 805 is that by having wave rail segments 805, two non-wave rails are provided. Unlike the case of adopting the design configuration using, the degree of freedom in designing the configuration of the plurality of cell structures in the proximal tapered end portion 801 is improved. As shown in FIG. 45B, a non-corrugated rail segment 804 is formed along the plurality of outer cell structures 811, which are considerably more than structures similar to those shown in FIG. 30, for example. It has a plurality of structures having strong symmetry.

  Referring to FIG. 45C, according to one embodiment, the retrieval device 800 has the following dimensional characteristics when cut (as-cut, cut into a flat shape for deployment). Specifically, L1 = 56.44 mm plus / minus 0.50 mm, L2 = 26.85 mm plus / minus 0.50 mm, L3 = 2.0 mm plus / minus 0.1 mm, L4 = 4.0 mm plus or minus 0.3 mm, W1 = 0.0054 inch plus or minus 0.0004 inch, W2 = 0.0056 inch plus or minus 0.0004 inch, W3 = 0.0047 inch -Plus / minus 0.0004 inch, W4 = 0.0047 inch-Plus / minus 0.0004 inch, W5 = 0.0040 inch-Plus / minus 0 0004 inches, W6 = 0.0027 inches plus or minus 0.0004 inches, W7 = 0.0034 inches plus or minus 0.0004 inches, W8 = 0.0031 inches plus or minus 0.0004 inches W9 = 0.010 inch plus minus 0.007 inch, W10 = 0.0015 inch plus minus 0.0004 inch, and W11 = 0.005 inch plus minus 0.0004 inch. is there. In one embodiment, the length dimension of the proximal tapered end 801 and the length dimension of the distal tapered end 803 are about 13 mm and about 7 mm, respectively.

  FIG. 46 shows an embolic retrieval device 830 according to another embodiment, in which some portions of several struts 832 at the distal tapered end 831 of the retrieval device 830. 833 has a flare (flare, conical, divergent), which improves the radiopacity of the distal portion of the retrieval device 830. In some embodiments, during manufacture, each of the portions 833 has a wider portion that is laser cut, thereby expanding than the rest of the struts 832. In addition to improving the radiopacity of the portions 833 themselves, the flared portions (or some of the wide portions) allow the radiopaque film, eg, gold film, to be An excellent platform to accept such things will be realized. In the embodiment shown in FIG. 46, the flared portions 88 are arranged at a sufficient distance from the connection point 834 between the struts so as not to hinder the ability of the recovery device 830 to be compressed (compressibility). Yes. In the embodiment shown in FIG. 46, the flare portions 833 are further offset from each other in the long axis direction so that only one flare portion 833 is present when the recovery device 830 is in a compressed state. Occupies a position on the long axis. Such a configuration mitigates the impact that the flared portions 833 may have on the minimum diameter dimension achievable by the retrieval device 830 at a location along the distal tapered end 831. In the embodiment shown in FIG. 46, the flare portions 833 have a plurality of nodes, each having a diameter of about 0.015 inches in one embodiment. In some other embodiments, the flared portions 833 can each have a width dimension in the range between about 0.0035 inches and about 0.0045 inches.

  47A and 47B illustrate a distal segment of an embolus retrieval device 480 according to one embodiment. FIG. 47A shows the collection device 480 in a two-dimensional planar deployment, that is, as if it were cut along its length and deployed on a single plane. FIG. 47A shows the recovery device 480 in a cut shape (as-cut configuration, a shape when cutting is performed for development to form a flat shape), while the three-dimensional display in FIG. Reference numeral 480 denotes a post-cut manufactured state after cutting (a state in which a laser is cut for manufacturing to form a cylinder).

  Referring to FIG. 47A, the distal segment of the retrieval device 480 has a plurality of distally located cell structures 488-491, with a set of antennas 481, 482 and 483. Extends distally from the connections 492-494 of the cell structure 488-491. In some embodiments, a plurality of tabs 485-487 or a plurality of other dimensionally enlarged dimensioning features of the plurality of distal-most cell structures 488-491 located distally Provided at one or more ends, the purpose of which is to identify the distal end of the retrieval device 480 under fluoroscopy, the identification being the characteristics of the dimensioning feature and / or the X-ray As a result of the benefits of permeable materials. As shown in FIG. 47A, in some embodiments, the plurality of distal-most cell structures 488-491 are smaller than the cell structures adjacent to each other within the body of the retrieval device 480.

  As shown in FIG. 47B, at some point after the retrieval device 480 is formed by a method such as laser cutting, the distal ends of the antennas 481, 482 and 483 are coupled together at a connection point 484, Thereby, the internal cavity of the retrieval device 480 is provided with a closed-end. In fact, its closed end forms a basket, which is a collection of particles, eg, embolic material, that can be scattered during the retrieval operation. Promote. In some embodiments, connection point 484 is formed by soldering the respective distal ends of antennas 481-483 to each other by soldering. In some embodiments, each distal end of the antenna 481-483 is a coil spring or other encasement, such as a perforated structure. And, accordingly, solder or other bonding agent is applied in and / or around the housing, thereby allowing each of the antennas 481-483 to be The distal ends are joined together. In some embodiments, the receptacle has a rounded atraumatic distal tip. In some embodiments, the housing includes a radiopaque material.

  48A and 48B illustrate an embolus retrieval device 850 according to one embodiment. FIG. 48A shows the collection device 850 in a two-dimensional plane deployment state, i.e., as if it was cut along its length and deployed on a plane. FIG. 48A shows the recovery device 850 in a cut shape (as-cut configuration, a shape when cutting is performed for deployment to form a flat shape), while the three-dimensional display in FIG. Reference numeral 850 denotes a post-cut manufactured state after cutting (a state in which a laser is cut for manufacturing to form a cylinder). The retrieval device 850 includes a proximal antenna 851, a proximal tapered portion 852, a main body portion 853, and a distal portion 855. In a post-cut manufactured state after cutting, the body 853 and the distal portion 855 are completely the same or substantially the same. Have the same diameter. At some point after the retrieval device 850 is formed, for example, by laser cutting, the retrieval device 850 has a body portion in which the unconstrained configuration of the distal portion 855 is in an unconstrained state. Formed to have a diameter greater than 853. The post-cut form of the recovery device 850 (post as-cut form, which is formed into a cylinder by laser cutting for manufacturing) can be achieved by using a mandrel or another tool and methods known in the art. May be achieved. In some embodiments, the ratio of the unconstrained diameter of the distal portion 855 (when the shape transition portion 854 is not present) to the diameter of the body portion 853 is about 1.2 / 1.0 and about 2 Within the range between 0.0 / 1.0. For example, according to one embodiment, the unrestrained average diameter of the body portion 853 is about 2.0 mm and the unrestrained average of the distal portion 855 when the shape transition portion 854 is not present. The diameter is about 4.0 mm. According to some embodiments, the ratio of the unrestrained length of the distal portion 855 (when no shape transition portion 854 is present) to the length of the body portion 853 is about 0.2 and about 0.7. Is in the range between. For example, according to one embodiment, the unrestrained length of the body portion 853 is in a range between about 15 mm and about 25 mm, and the distal portion 855 (when the shape transition portion 854 is not present) ) In the range between about 5 mm and about 10 mm.

  According to some embodiments, as shown in FIG. 48A, the plurality of cell structures in the body portion 853 have a larger size than the plurality of cell structures in the distal portion 855. Since the strut density of the main body portion 853 is lower than other portions, the integration of the recovery device 850 into the embolus is promoted. Since the strut density of the distal portion 855 is higher than that of other portions, capture of a plurality of scattered particles is promoted as will be described in detail later. Further, in some embodiments, the retrieval device 850 is configured in a way and the method is used so that the retrieval device 850 is deployed in a patient's conduit. A radial force greater than the radial force generated at the distal portion 855 is configured to be generated at the body portion 853. In such an embodiment, the body 853 is positioned to capture the embolus, while the distal portion 855 is more gentle so as to press the portion of the conduit wall away from the embolus. Thereby capturing a plurality of portions of the embolus that become scattered during and after the capture. Thus, according to one method, the retrieval device 850 is positioned at the treatment site of the patient by use of a delivery catheter, as previously described herein. This retrieval device 850 is positioned at the distal end of the delivery catheter, thereby positioning the body 853 at the location of the embolus to be retrieved. The body portion 853 and the distal portion 855 have completely or substantially the same diameter when enclosed within the delivery catheter. Thereafter, the delivery catheter is pulled proximally, the purpose of which is to expand the constrained retrieval device 850 at the treatment site, with the body 853 at least partially in the embolus. And at least a portion of the distal portion 855 is more gently supported by a portion of the conduit wall away from the embolus. Once the embolus is captured within the body 853 of the retrieval device 850, the retrieval device 850 is removed from the patient by a method consistent with one or more of the methods previously described herein. Also good. During the performance of such an extraction operation, as the retrieval device 850 is pulled in a proximal manner, the distal portion 855 sweeps along the tube wall, thereby causing the emboli to be scattered. Multiple parts that are not captured are captured. Thanks to the expanded diameter dimension, the distal portion 855 remains in contact with the tube wall during the entire or part of the extraction process.

  As described above, when the strut density of the main body portion 853 is lower than other portions, it is facilitated that the recovery device 850 is integrated in the embolus. However, in some embodiments, the retrieval device 850 is configured in a way and the method is used so that the retrieval device 850 is deployed in the patient's conduit. The body portion 853 is configured to apply a greater radial force than the distal portion 855 applies. According to that method, the retrieval device 850 ultimately has a radial direction that is greater than the radial force generated at the distal portion 855 when the body portion 853 is deployed within the patient's conduit. A force is generated in the main body 853. In order to achieve a situation where the magnitude of the radial force varies from site to site, in some embodiments, the width dimension of each of the plurality of struts in the body 853 of the retrieval device 850 is determined by the distal portion 855. It cut | disconnects so that it may become larger than each width dimension of at least one part or all of the some struts of inside.

As shown in FIGS. 48A and 48B, in some embodiments, the strut density of the distal portion 855 provides a plurality of non-linear struts 860 on at least some of the plurality of cell structures. It is further increased. In some embodiments, a non-linear strut 860 extends between the proximal end 864 and the distal end 866 of each of the plurality of cell structures. In some embodiments, a non-linear strut 860 extends between the proximal end 864 and the distal end 866 of each of the plurality of cell structures, so that the non-linear strut 860 is It has substantially the same length as the upper strut 861 and / or the lower strut 862 in the shape (as-cut configuration, the shape when a flat shape is formed by cutting for deployment). With such a configuration, the ability of the cell structure struts to be nested with each other is improved, and as a result, the diameter of the recovery device 850 that can be achieved is reduced. In some embodiments, a non-linear strut 860 extends between the proximal end 864 and the distal end 866 of each of the plurality of cell structures, and accordingly, an upper strut 861, a lower strut 862, and Each of the non-linear struts 860 has a length that substantially matches each other in the shape at the time of cutting (as-cut configuration, the shape at the time of cutting for deployment to form a flat shape). In order to ensure that the radial force generated in the distal portion 855 is not significantly affected, in some embodiments, the non-linear struts 860 are provided with the width dimensions of the upper and lower struts 861 and 862. Has a smaller width dimension. In some embodiments, the ratio of the width dimension of the non-linear strut 860 to the width dimension of the upper strut 861 and the ratio of the width dimension of the non-linear strut 860 to the width dimension of the lower strut 862 are both Within a range between about 0.70 and about 0.80. For example, according to one embodiment, each of the upper strut 861 and the lower strut 862 has a width dimension of about 0.0035 inches, and accordingly, the non-linear strut 860 has a width of about 0.0025 inches. Have dimensions.

  FIG. 49 shows a modification of the cutting shape shown in FIG. 48A (as-cut configuration, the shape when cutting is performed for development to form a flat surface). As shown in FIG. 49, the retrieval device 870 has a proximal portion 871, a body portion 872, and a distal portion 873, the distal portion 873 being shorter than the distal portion 855 shown in FIG. 48A. Has a length.

  FIG. 50 shows a distal segment of a retrieval device that approximates the retrieval device shown in FIGS. 47A and 47B, the distal segment comprising one or more wires 495 that are radiopaque. Alternatively, the ribbon 495 includes a ribbon 495 that is wound around a plurality of struts forming a plurality of cell structures 488-492. Throughout the remainder of this specification, the term “wire” is used broadly to include wires, ribbons, or other similar structures. As shown in FIG. 50, one or more wires 495 having radiopacity may be wound around all of the cell struts forming the cell structures 488-492. In this alternative embodiment, only selected ones of the struts may have windings of wires 495 that are radiopaque. The advantage of incorporating a wire 495 winding with radiopacity into the distal segment of the retrieval device is improved visibility of the distal end of the retrieval device under fluoroscopy. Is to do. On the other hand, for example, as shown in FIG. 50, when a sufficient number of distal struts benefit from the winding portion, the winding portion increases the rigidity of the distal segment. An advantage of the increased rigidity of the distal segment is that it is prevented from collapsing when the retrieval device is advanced through the delivery catheter or patient conduit. In one embodiment, the one or more wires 495 contain platinum. However, it should be understood that any of a plurality of other radiopaque materials may be used. The wire or wires 495 have a core structure, such as stainless steel, that is clad with a radiopaque material or coated with other methods. May be. The one or more wires 495 are further polymeric structures that are impregnated, doped or otherwise coated with a radiopaque material. (coated). In some embodiments, the cross-sectional area of one or more wires 495 is changed such that the impermeability and / or stiffness changes within the distal segment. In some embodiments, the diameter or width dimension of the one or more wires 495 is between about 20% and about 50% less than the plurality of struts forming the distal segment. Is in.

  Although not shown in FIG. 50, in some embodiments, a plurality of small recesses are provided in at least a portion of the plurality of struts forming the plurality of cell structures 488-492, the purpose of which is shown in FIG. Is to guide the installation of the winding portion at a predetermined position. Desirably, the recesses accommodate only a portion of the wire 495 such that only a portion of the wire 495 is retained within the recess and a portion of the wire 495 is disposed outside the recess. Have a size.

  51A-51D illustrate some other aspects of the thrombectomy device 550, which are in some respects similar to the collection device 850 shown in FIGS. 48A and 48B. 51A-51D show the collection device 550 in a two-dimensional planar deployment, that is, as if it were cut along its length and deployed on a single plane. The retrieval device 550 includes a proximal antenna 561, a proximal tapered portion 551, a main body portion 552a, and a distal portion 552b. In an as-cut manufactured state after cutting, the body portion 552a and the distal portion 552b are completely the same or Have substantially the same diameter. At some point after the retrieval device 550 is formed by a method such as laser cutting, the retrieval device 550 has a body portion in which the unconstrained configuration of the distal portion 552b is in an unconstrained state. Formed to have a diameter greater than 552a. The post-cut form of the recovery device 550 (post as-cut form, which is formed into a cylinder by laser cutting for manufacturing) can be achieved by using a mandrel or another tool and methods known in the art. May be achieved. In some embodiments, the ratio of the unconstrained diameter of the distal portion 552b to the diameter of the body portion 552a is between about 1.2 / 1.0 and about 2.0 / 1.0. Is in range. For example, according to one embodiment, the unrestrained average diameter of the body portion 552a is about 2.0 mm, and the unrestrained average diameter of the distal portion 552b is about 4.0 mm. According to some embodiments, the ratio of the unconstrained length of the distal portion 552b to the length of the body portion 552a is in a range between about 0.2 and about 0.7. For example, according to one embodiment, the unrestrained length of the body portion 552a is in a range between about 15 mm and about 25 mm, and the unrestrained length of the distal portion 552b is Within a range between about 5 mm and about 10 mm.

In some embodiments, in a proximal taper (proximal end) 551, a body (proximal part of the body) 552a and a distal part (proximal part of the body) 552b The plurality of cell structures have different sizes. In the example shown in FIG. 51A, the cell sizes (areas) of these cell structures are in a multiple relationship with each other, and accordingly, the cell structure 554 is almost equal to the cell structure 553 for two cells. The cell structure 555 has an area substantially equal to that of the three cell structures 553. It is important to note that it is not essential that the cell size (area) of each of these cell structures is a multiple of each other. FIG. 51B shows the length dimension L1 and the width dimension W1 of the cell structure 553. FIG. 51C shows the length dimension L2 and the width dimension W2 of the cell structure 554. FIG. 51D shows the length dimension L3 and the width dimension W3 of the cell structure 555.

  According to some embodiments, each of the cell structures 553, 554 and 555 has an average length / width ratio (length) greater than 1 when the retrieval device 550 is in an unexpanded state and an expanded state. to width ratio). Due to the ability of cell structures 553, 554 and 555 to maintain an average length to width ratio greater than 1, these cell structures 553, 554 and 555 can be used by the retrieval device 550 to deliver a catheter or patient. As it travels through the conduit, it is prevented from collapsing (buckling) in the longitudinal direction. That is, the plurality of cell structures of the recovery device 550 are in an accordion like fashion, in the long axis direction, due to their length / width ratio being greater than 1. , The cell structure itself is prevented from collapsing (buckling).

  Another aspect is reflected in the respective length dimension L3 of the plurality of cell structures 555 in the distal portion 552b of the retrieval device 550. Since the distal portion 552b has an expanded diameter that is larger than the expanded diameter of the rest of the retrieval device 550, the length dimension L3 is sufficiently larger than the width dimension W3. As a result, it is ensured that the cell structure 555 remains its length dimension larger than the width dimension when the recovery device 550 transitions from the unexpanded state to the expanded state. Is done.

  In some embodiments, the average length / width ratio of the plurality of cell structures in the distal portion 552b of the body portion is the average of the plurality of cell structures in the proximal portion 552a of the body portion. The average length / width ratio of the plurality of cell structures in the proximal portion 552a of the main body portion is larger than the length / width ratio, and the average length / width of the plurality of cell structures in the proximal end portion 551 is larger. And the average length / width ratio of the plurality of cell structures in the proximal end 551 is greater than 1 when the self-expanding member is in the unexpanded and expanded states.

  In some embodiments, the retrieval device 550 is configured in a way and the method is used so that the retrieval device 550 is distant when the retrieval device 550 is deployed in a patient's conduit. A radial force larger than the radial force generated at the positioning portion 552b is configured to be generated at the main body portion 552a. In such an embodiment, the body portion 552a is positioned to capture the embolus, while the distal portion 552b is more gentle so as to press the portion of the vessel wall away from the embolus. Thereby capturing a plurality of portions of the embolus that become scattered during and after the capture. Thus, according to one method, the retrieval device 550 is positioned at the treatment site of the patient through the use of a delivery catheter, as previously described herein. The retrieval device 550 is positioned at the distal end of the delivery catheter, thereby positioning the body 552a where the emboli is to be retrieved. Body portion 552a and distal portion 552b have completely or substantially the same diameter when enclosed within the delivery catheter. Thereafter, the delivery catheter is pulled proximally, the purpose of which is to expand the constrained retrieval device 550 at the treatment site, with the body portion 552a at least partially in the embolus. And at least a portion of the distal portion 552b is more gently supported by the portion of the vessel wall away from the embolus. Once the embolus is captured within the body portion 552a of the retrieval device 550, the retrieval device 550 is removed from the patient by a method consistent with one or more of the methods previously described herein. Also good. During the performance of such removal, as the retrieval device 550 is pulled in a proximal manner, the distal portion 552 may sweep along the tube wall, thereby causing the emboli to be scattered. Multiple parts that are not captured are captured. Thanks to the expanded diameter dimension, the distal portion 552b continues to contact the tube wall during the entire or part of the removal process.

  As described above, the low strut density of the main body portion 552a (compared to the strut density of the proximal taper portion 551) facilitates integration of the recovery device 550 into the embolus. However, in some embodiments, the retrieval device 550 is configured in a manner and the method is used so that the retrieval device 550 is deployed when the retrieval device 550 is deployed in a patient's conduit. The body portion 552a is configured to apply a radial force greater than the radial force applied by the distal portion 552b. In order to achieve a state where the magnitude of the radial force varies from site to site, in some embodiments, the width dimension of each of the plurality of struts in the body portion 552a of the retrieval device 550 is determined by the distal portion 552b. It cut | disconnects so that it may become larger than each width dimension of at least one part or all of the some struts of inside.

  As shown in FIG. 51A, in some embodiments, the strut density of the distal portion 552b is further increased by providing a plurality of non-linear struts 562 in at least some of the plurality of cell structures. It has been. In some embodiments, a non-linear strut 562 extends between the proximal end 556 and the distal end 557 of each of the plurality of cell structures. In some embodiments, non-linear struts 562 (ie, intermediate struts, struts that pass through the center of the cell structure) are connected to the proximal end 556 and the distal end of each of the plurality of cell structures. Accordingly, the non-linear strut 562 has an upper strut 558 in the cut-off configuration (the as-cut configuration). And / or have the same length as the lower strut 559. Such a configuration improves the ability of the cell structure struts to be nested with each other, thereby reducing the diameter of the recovery strut 550 that can be achieved. In some embodiments, the non-linear struts 562 may have a width dimension of the upper strut 558 and the lower strut 559 so that the radial force generated in the distal portion 552b is not significantly affected. Has a smaller width dimension. In some embodiments, the ratio of the width dimension of the non-linear strut 562 to the width dimension of the upper strut 558 and the ratio of the width dimension of the non-linear strut 562 to the width dimension of the lower strut 559 are both: Within a range between about 0.70 and about 0.90. For example, according to one embodiment, each of the upper strut 558 and the lower strut 559 is approximately 0.0035 inches, with an as-cut width dimention, cut for deployment and planar. As a result, the non-linear strut 562 is approximately 0.0025 inches, as-cut width dimention, cut into a planar shape for deployment. Width dimension when forming.

  Although not shown in FIGS. 51A-51D, in some embodiments, a plurality of cell structures in the distal portion 552b have a plurality of winding portions, the winding portions being It is selectively woven to pass through a plurality of struts, the purpose of which is to provide the desired radiopaque and / or stiffness to the distal portion 552b as described above in connection with FIG. It is.

  In some embodiments, antennas 560a, 560b, and 560c are each within distal portion 552b, the farthest from the most distal of the plurality of rows of circumferentially aligned cell structures. It extends in the lateral direction. 47A and 47B, the distal ends of antennas 560a, 560b and 560c are coupled to each other in a manner as described above with reference to the retrieval device 480 shown in FIGS. A partially closed-end is provided. In fact, its closed end forms a basket, which is a collection of particles, eg, embolic material, that can be scattered during the retrieval operation. Promote. In some embodiments, the connection points of antennas 560a, 560b and 560c are formed by soldering the respective distal ends of antennas 560a, 560b and 560c together by soldering. In some embodiments, the distal end of each of the antennas 560a, 560b and 560c is encasement, such as a coil spring or other perforated structure. And, accordingly, solder or other bonding agent is applied in and / or around the housing, thereby providing antennas 560a, 560b and The respective distal ends of 560c are joined together. In some embodiments, the receptacle has a rounded atraumatic distal tip. In some embodiments, the housing includes a radiopaque material.

FIG. 52A shows a collection device similar to that disclosed in FIGS. 51A-51D. The difference is in the configuration of a plurality of non-linear / intermediate struts 570, which are arranged in a plurality of cell structures 555 located at the distal portion. As shown in FIG. 52A, the intermediate strut 570 has first and second curved elements 571 and 572, and bifurcations 573a and 573b are interposed between the first and second curved elements 571 and 572. Have. An advantage of adopting the strut 570 configuration is that, compared to strut 562, another coverage is provided to assist in capturing embolic debris. In some embodiments, a non-linear strut 570 extends between the proximal end 556 and the distal end 557 of the cell structure 555. In some embodiments, a non-linear strut 570 extends between the proximal end 556 and the distal end 557 of the cell structure 555, which is associated with an as-cut configuration. Therefore, the length dimension of the upper strut 558 is a combination of the length of the first curved element 571, the length of the second curved element 572, and the length of the branch strut 573a. The length dimension of the length of the first strut element 571, the length of the second curb element 572, and the length of the branch strut 573b is substantially equal to the length of the lower strut 559. In some embodiments, the non-linear struts 570 have a width dimension of the upper strut 558 and the lower strut 559 so that the radial force generated in the distal portion 552b is not significantly affected. Has a smaller width dimension. In some embodiments, the ratio of the width dimension of the non-linear strut 570 to the width dimension of the upper strut 558 and the ratio of the width dimension of the non-linear strut 570 to the width dimension of the lower strut 559 are both: Within a range between about 0.70 and about 0.90. For example, according to one embodiment, each of the upper strut 558 and the lower strut 559 is approximately 0.0035 inches, with an as-cut width dimension, cut and flattened for deployment. Accordingly, the non-linear strut 570 has a cut width dimension of about 0.0025 inches.

  FIG. 52B shows a variation of the retrieval device shown in FIG. 52A, which differs from FIG. 52A in the size of the cell structure 579 in the proximal section 575 of the body. There are points and points having a plurality of cell structures 577 in the distal section 576 of the body. As shown in FIG. 52B, the addition of another plurality of struts (shown in broken lines) to substantially halve the size of the cell structure 579 results in the size of the cell structure 579 in FIG. 52A. It is smaller than the cell structure arranged in the same manner as the cell structure 579 in the collection device shown. As noted above, another difference is that a plurality of cell structures 577 are provided at the distal end of the retrieval device, thereby providing the retrieval device with a substantially circular end. It is to be given that the position in the length direction is uniform. In one embodiment, intermediate struts 578 extend between the ends of cell structure 577 in a manner similar to that described above for intermediate struts 562.

  FIG. 53 shows a recovery device 580, which has a plurality of cell structures whose lengths are different from each other in the longitudinal direction, and these cell structures are shown in FIG. Similar to the multiple cell structures described above in relation to the collection device 550 shown in FIG. 51D. FIG. 53 shows the collection device 580 in a two-dimensional plane development state, that is, as if it has been cut out along its length and developed on one plane. The retrieval device 580 includes a proximal antenna 581, a proximal tapered portion 582, a body portion 583, and a distal portion 584. In a post-manufactured state (as-cut manufactured state), the body portion 583 and the distal portion 584 are completely the same or Have substantially the same diameter. At some point after the retrieval device 580 has been formed, for example, by laser cutting, the retrieval device 580 has a body portion in which the unconstrained configuration of the distal portion 584 is in an unconstrained state. It is formed to have a diameter greater than 583. The post-cut form of this collection device 580 (post as-cut form, which is a cylinder that has been laser cut for manufacturing) can be obtained by using a mandrel or another tool and methods known in the art. May be achieved. In some embodiments, the ratio of the unrestrained diameter of the distal portion 584 to the diameter of the body portion 583 is between about 1.2 / 1.0 and about 2.0 / 1.0. Is in range. For example, according to one embodiment, the unrestrained average diameter of the body portion 583 is about 2.0 mm, and the unrestrained average diameter of the distal portion 584 is about 4.0 mm.

  As shown in FIG. 53, the plurality of cell structures in the proximal taper portion (proximal end portion) 582, the main body portion 583, and the distal portion 584 have different sizes from each other. In the example shown in FIG. 53, the cell sizes (areas) of these cell structures are in a multiple relationship with each other, and accordingly, the cell structures 586 are almost equal to the cell structures 585 for two. The cell structure 587 has an area substantially equal to that of the three cell structures 585. It is important to note that it is not essential that the cell size (area) of each of these cell structures is a multiple of each other. Similar to the cell structures 553, 554, and 555 in the collection device 550 described above, each of the cell structures 585, 586, and 587 is when the collection device 580 is in an unexpanded state and an expanded state. Have an average length to width ratio of greater than 1. As described above, the ability of the cell structures 585, 586 and 587 to maintain an average length to width ratio greater than 1 allows the cell structures 585, 586 and 587 to be As it is advanced through the delivery catheter or patient conduit, it is prevented from collapsing (buckling) in the longitudinal direction. That is, the plurality of cell structures of the collection device 580 are in an accordion like fashion due to their length / width ratio being greater than 1, in the long axis direction, and , The cell structure itself is prevented from collapsing (buckling).

  Another aspect is reflected in the respective length dimensions of the plurality of cell structures 587 in the distal portion 584 of the retrieval device 580. Since the distal portion 584 has an expanded diameter that is larger than the expanded diameter of the rest of the retrieval device 580, the length dimension of the cell structure 587 is equal to its width dimension. It is sufficiently long as a result, so that the cell structure 587 maintains its length dimension larger than the width dimension when the retrieval device 580 transitions from the unexpanded state to the expanded state. To be ensured.

  In some embodiments, the retrieval device 580 is configured in a manner and the method is used so that the retrieval device 580 is distant when the retrieval device 580 is deployed within a patient's conduit. A radial force larger than the radial force generated at the positioning portion 584 is configured to be generated at the main body portion 583. In such an embodiment, the body portion 583 is positioned to capture the embolus, while the distal portion 584 is more gentle so as to press a portion of the vessel wall away from the embolus. Thereby capturing a plurality of portions of the embolus that become scattered during and after the capture. Thus, according to one method, the retrieval device 580 is positioned at the treatment site of the patient through the use of a delivery catheter, as previously described herein. The retrieval device 580 is positioned at the distal end of the delivery catheter, thereby positioning the body 583 where the emboli is to be retrieved. The body portion 583 and the distal portion 584 have completely or substantially the same diameter when enclosed within the delivery catheter. Thereafter, the delivery catheter is pulled proximally, the purpose of which is to expand the constrained retrieval device 580 at the treatment site, with the body portion 583 at least partially in the embolus. And at least a portion of the distal portion 584 is more gently supported by a portion of the conduit wall away from the embolus. Once the embolus is captured within the body 583 of the retrieval device 580, the retrieval device 580 is removed from the patient by a method consistent with one or more of the methods previously described herein. Also good. During the performance of such an extraction action, as the retrieval device 580 is pulled in a proximal manner, the distal portion 552 may sweep along the vessel wall, thereby causing the emboli to be in a scattered state. Multiple parts that are not captured are captured. Thanks to the expanded diameter dimension, the distal portion 584 remains in contact with the tube wall during the entire or part of the removal process.

  Although not shown in FIG. 53, in some embodiments, a plurality of cell structures within the distal portion 584 have a plurality of winding portions, the winding portions comprising a plurality of winding portions. It is selectively woven to pass through the struts, the purpose of which is to provide the desired impermeability and / or stiffness to the distal portion 584 as described above in connection with FIG.

  The recovery device 590 shown in FIG. 54 is common to the recovery device 580 shown in FIG. 58, but is different in that a plurality of cell structures 587 are connected to each other. The plurality of cell structures 587 has a proximal side 591, a distal side 592, a top side 593, and a bottom side 594. As shown in FIG. 54, the plurality of cell structures 587 are connected to the cell structures 586 adjacent thereto and along at least a part of the proximal side 591. However, the top side 593 and the bottom side 594 of the plurality of cell structures 587 are not connected to each other. As described above, the length / width ratio of the cell structure 587 is desirably maintained at a value greater than 1 as the retrieval device 590 moves within the delivery catheter or patient conduit. By making the cell structure 587 in a disconnected state at the top side 593 and the bottom side 594, normally, the cell structure 587 is added to a plurality of cell structures 587 during expansion, and the width dimensions of the cell structures 587 The force that would significantly expand is greatly eliminated. This helps to maintain the length / width ratio of the cell structure 587 at a value greater than 1 when the collection device 590 is in the expanded state. As shown in FIG. 55, the plurality of cell structures arranged in a row in the circumferential direction at the most distal position are disconnected from each other, so that a plurality of cell structures that are smaller than the others are selected. It becomes possible to do. For example, as shown in FIG. 55, the plurality of cell structures 596 aligned in the circumferential direction at the most distal position are the same as or similar to the plurality of cell structures 586 located at the proximal position. It is possible to have a plurality of cell structures. However, it should be understood that the size and shape of each of the plurality of cell structures 596 aligned in the circumferential direction at the most distal position is the same as the size of each of the plurality of cell structures 586 positioned proximally. It is not essential to approximate the size and shape.

  Next, referring to FIG. 56A, a recovery device 630 is shown. This recovery device 630 has a configuration common to that of the recovery device 800 shown in FIG. 45A, but the number of cell structures is small. The difference is that it uses smaller diameter vessels / ducts. FIG. 56A shows a two-dimensional view of a retrieval device 630 according to another embodiment. The retrieval device 630 has a self-expanding member that has a proximal tapered end 631, a tubular body 632, and a distal tapered end 633. The outermost cell structures located on the outermost side within the proximal taper end 631 have a plurality of outer wall segments that, on one side, are non-wavy rail segments ( Rail) 636, while on the other side, a wavy rail segment (rail) 637 is formed. Each of the rail segments 636 and 637 extends from the most proximal end of the self-expanding member to the same position as the proximal end of the tubular body 632 or a position near it. Proximal antenna 634 extends proximally from the proximal most proximal cell structure 638, while distal antenna 635 extends distally from the distal end of distal tapered end 633. ing. Each of the plurality of cell structures 640 in the cylindrical body 632 has a proximal flexure element 641 and a distal flexure element 642 facing each other, and The proximal deflection element 641 and the distal deflection element 642 each generally have a convex and / or concave structure, such as, for example, a V-shaped structure and a U-shaped structure. The proximal deflection element 641 and the distal deflection element 642 are connected to each other by a pair of struts 643 and 644, each of which is diagonally extending (diagonally). extending at an angle) and at a distance from each other in the circumferential direction.

  FIG. 56B shows the as-cut width dimention of various struts in the proximal tapered end 631 according to one embodiment. Are expressed in units of inches, and each width dimension has a dimensional tolerance of plus or minus 0.004 inches. According to one embodiment, each of the plurality of struts in the proximal tapered end 631 has an as-cut thickness dimention of 0.0045 plus or minus 0.004 inches for deployment. (Thickness dimension when cut to form a flat surface).

  As described above, the cylindrical body 632 is used to integrate at least partially the embolus, which is the target site whose multiple struts are completely or partially excluded. It is desirable to have sufficient radial strength. However, the radial strength of the tubular body 632 needs to be low enough so as not to cause undue damage to the blood vessel or conduit during treatment. In order to achieve a desired radial strength, it is necessary to appropriately determine the cross-sectional area and / or the width dimension and / or the thickness dimension of each of the plurality of struts forming the cylindrical body portion 632.

  Another feature to consider is the flexibility feature. The tubular body 632 should be flexible enough that the retrieval device 630 can be advanced and retracted to pass through the patient's serpentine-bent anatomical site. However, the tubular body 632 is further rigid enough to be able to be pushed through the delivery catheter and the patient's conduit without collapsing (buckling) overlying itself. Should also have. It has been noted that stiffness acts as a factor in the ability of the retrieval device 630 to be withdrawn from the delivery catheter at some point after being deployed in the patient's body. As described above, if the retrieval device 630 is misplaced in the patient's conduit, or sometimes the retrieval device 630 is removed from the patient, the retrieval device 630 is Fully or partially withdrawn and accommodated in the delivery catheter. It has been noted that if the tubular body 632 does not have the required rigidity, it is difficult to pull the retrieval device 630 back into the delivery catheter after deployment. That is. According to several tests, in some cases where all the struts in the tubular body 632 have a uniform cross section, the struts have a size to achieve the appropriate radial force and are rigid. Proved to be lacking.

  It has been noted that the cross sections of the proximal and distal deflecting elements 641 and 642 have a significant effect on the radial force in the tubular body 632, whereas the obliquely oriented struts 643 and 644 Each cross section contributes only a little, if any, to the radial force generated in the tubular body 632. According to some embodiments, to achieve a proper balance of radial strength and stiffness within the tubular body 632, the cross-sections of the proximal deflection element 641 and the distal deflection element 642 are obliquely oriented. The cross sections of the struts 643 and 644 are different. In many cases, the retrieval device 630 is fabricated by cutting a tube having a uniform thickness dimension, so that the width dimensions and obliquely oriented struts 643 of the proximal deflection element 641 and the distal deflection element 642, respectively. And 644's respective width dimensions are varied to achieve desirable properties for radial force and stiffness. However, it should be understood that some dimensions, except the width dimension, may be varied to achieve the same or similar effect.

  According to some embodiments, all or some of the plurality of struts in the tubular body 632 have the same thickness dimension, and accordingly the proximal deflection element 641 and the distal deflection element. Each of 642 has a first average width dimension, and each of diagonally oriented struts 643 and 644 has a second average width dimension that is longer than the first average width dimension. The second average width dimension has a length sufficient to compensate for the lack of rigidity that would exist if the second average width dimension was the same as the first average width dimension. In some embodiments, the second average width dimension at the time of cutting (as cut, when unfolded to form a plane) is the first average as-cut The width dimension is in a range from about 1.1 times to about 2.0 times. In some other embodiments, the as-cut second average width dimension is about 1.2 times the as-cut first average width dimension about 1.2 times. It is within the range up to 5 times the value. According to some experimental examples, the first average width dimension at cut is about 0.0032 inches, and the second average width dimension at as-cut is about 0.003. It was 0040 inches. The experimental results show that the average deflection stiffness of the cylindrical body 632 is about 40 as a result of increasing the respective width dimension of the obliquely oriented struts 643 and 644 from 0.0032 inches to 0.0040 inches. % Increased in increments within the range of about 50%. This is not accompanied by a significant increase in radial force.

  FIG. 57 shows a recovery device 650, which has a configuration common to the recovery device 630, but differs in the configuration of the obliquely oriented struts 643 and 644. As shown in the figures (FIGS. 56A and 57), the diagonally oriented struts 643 and 644 in the retrieval device 630 are curvilinear, whereas the diagonally oriented struts 643 and 644 in the retrieval device 650 are respectively curved. Is linear.

  According to some embodiments, the respective width dimensions of the diagonally oriented struts 643 and 644 are uniform along their length. In connection with the previous example regarding dimensions, the example means that each of the obliquely oriented struts 643 and 644 has an average width dimension of 0.0040 inches over their entire length. Become. In some other embodiments, each of the obliquely oriented struts 643 and 644 has a central segment positioned between the paired proximal and distal end segments, Accordingly, the proximal end segment is coupled to the proximal flex segment 641 and the distal end segment is coupled to the distal flex segment 642. Using the same dimensions as previously described, the proximal flex segment 641 and the distal flex segment 642, along with the proximal and distal end segments of each of the diagonally oriented struts 643 and 644, are 0.0032. The average width dimension of inches may have, while the central segment of each of the obliquely oriented struts 643 and 644 may have an average width dimension of 0.0040 inches. In some other embodiments, each of the obliquely oriented struts 643 and 644 has a central segment located between a pair of proximal and distal tapered end segments that are paired with each other. Accordingly, the proximal tapered end segment is coupled to the proximal flex segment 641 and the distal tapered end segment is coupled to the distal flex segment 642. Using the same dimensions as previously described, the proximal flex segment 641 and the distal flex segment 642 have an average width dimension of 0.0032 inches, and accordingly, each of the diagonally oriented struts 643 and 644, respectively. The central segment has an average width dimension of 0.0040 inches, and the average width dimension of each of the proximal tapered end segment and the distal tapered end segment is from 0.0032 inches to 0.0040 inches. Change.

  As described above in the explanation of the recovery device shown in FIG. 50, the method of weaving / winding the wire or ribbon around the plurality of struts of the recovery device is described as follows. Can be used for the purpose of improving the recovery and the purpose of changing the rigidity of the recovery device. In some of the embodiments described above, the discussion there has been limited to incorporating such features into the distal portion of the retrieval device. What will be described now relates to the use of this type of wire windings in another part of the recovery device.

FIG. 58A shows a collection device 660 , which has the same structure as the collection device 650 shown in FIG. The retrieval device 660 has a plurality of wires that are intended to improve the radiopacity of the retrieval device 660 and / or the rigidity of one or more portions of the retrieval device 660. Is wound around a selected one of a plurality of struts. In the preferred embodiment shown in FIG. 58A, three radiopaque wires (or ribbons) 661, 662, and 663 are knitted along the length of the retrieval device 660, the purpose of which is: This is to improve the radiopacity of the recovery device 660 substantially over its entire length and to improve at least the rigidity of the cylindrical main body 666. In the embodiment shown in FIG. 58A, the wires 661-663 are disposed around a plurality of struts (when viewed from the left to the right) extending obliquely downward in the cylindrical main body 666. Are knitted so that only the short leg 670a of each of the plurality of flexure elements 670 has a wire wrap. As shown in detail in FIG. 58B, the long leg 670b of each flexing element 670 has no or substantially no wire wrap. Thanks to this winding configuration, the wires 661-663 allow the recovery device 660, in particular the tubular body 666, to disproportionally affect the stiffness and radial force relative to each other. Can be applied. For example, the average flexural rigidity of the tubular body 666 increases from a moderately to a suddenly significant in the unexpanded state (contracted state, constrained state) of the tubular body 666. With this increase, the radial force applied by the tubular body 666 does not increase to the same extent. What has been demonstrated by several prototypes is that the average deflection stiffness of the tubular body 666 can be increased by up to 50%, and the increase in radial force associated therewith can be relatively small or zero. It is that there is sex.

  According to one preferred embodiment, each of the plurality of struts in the tubular body 666 has an as-cut thickness dimension of about 0.0045 inches, with the associated strut 670a. , 670b and 671 have width dimensions of about 0.0032 inches, about 0.0032 inches and about 0.0040 inches, respectively. In one embodiment, the wires 661-663 have platinum having a width dimension and / or diameter in the range between about 0.0020 inches and about 0.0025 inches, Accordingly, on average, the number of wire turns per strut is in the range of about 1 to about 10, and most commonly about 1 wire turn per strut. To about 5 times. It should be understood that a single wire or multiple wires can be used in place of the wire 661-663 structure shown in FIG. 58A. Further, it is important to note that when increasing radiopacity, one or more wires may be one of the plurality of radiopaque materials previously described in connection with FIG. It is possible to have a single opaque material or a combination of a plurality of radiopaque materials thereof. When multiple wire wraps are mounted for the sole purpose of changing stiffness, the wire or wires may be any material that meets that purpose, such as metallic materials, polymeric materials, and composites. It is possible to have something like a material. In some embodiments, the cross-sectional area of each of the one or more wires is used to achieve a state in which the radiopacity varies along the length dimension of the retrieval device. It is possible to vary along the dimensions.

  According to some embodiments, the tubular body 666 has a first average flexural rigidity when no wire or ribbon 661-663 (s) is present, and when present, , Having a second average deflection stiffness, and dimensional and material properties of the wire or ribbon 661-663, and extending diagonally within the tubular body 666 and spaced apart from each other in the circumferential direction. The number of wire turns per unit length of the plurality of struts is such that when the cylindrical main body 666 is in an unexpanded state, the second average deflection stiffness is about 1.2 times to about 1.8 times the first average deflection stiffness. Is selected to increase within a range up to 2 times (by a factor of between about 1.2 to about 1.8, with a factor in the range of about 1.2 times to about 1.8 times) Increased mean deflection stiffness Along, the rate of increase in low increasing rate such that the imbalance (a disproportionally lower increase), radial force exerted by the cylindrical body portion 666 is increased.

  According to some embodiments, as shown in FIG. 59, the proximal end segment of each of the wires 661-663 is coupled to the retrieval device 660, and as shown in FIG. A distal end segment of each of 663 is coupled to the retrieval device 660. It is important to note that other configurations for attachment / connection may exist. FIG. 59A shows a proximal attachment of wires 661-663 that attaches to the proximal antenna 675 at the distal end of the longitudinal wire 40 (see, eg, FIG. 1A). In the same position as In one embodiment, the distal end of the wire 40 has a flat shape with a width dimension of about 0.005 inches, and accordingly the width dimension and thickness dimension of the proximal antenna 675 are respectively About 0.0063 inches and about 0.0035 inches. FIG. 59B shows a cross-sectional view of the final formed joint, in which, in one embodiment, the proximal end (proximal) of each of the wires 661-663. End segment) is disposed on the bottom side of the proximal antenna 675 and the distal end of the longitudinal wire 40 is disposed on the top side of the proximal antenna 675.

  In one embodiment, the distal end of the elongated wire 40, the proximal end of each of the wires 661-663, and the proximal end of the proximal antenna 675 are coupled together in a coil structure (coil) 680. Has been. In one embodiment, the coil structure 680 includes a closely wrapped distal segment 680a and a loosely wrapped distal segment. 680b having one or more gaps 680c. In one embodiment, the length dimension of the proximal antenna 675 and the length dimension of the coil structure 680 are substantially coincident with each other. When the coil structure 680 is installed on a plurality of components that overlap each other, the elongated wire 40, the proximal antenna 675, and the wires 661-663 are connected to at least one of the coil structures 680. Along with the part, a bonding agent is introduced into the internal cavity of the coil structure 680 to bond together. In one embodiment, each end segment of the wires 661-663 is generally placed within a tightly wound distal segment (distal coil segment) 680a. The bonding agent can be an adhesive, solder or other suitable bonding agent. If the bonding agent is solder, the preceding step of the process includes coating the various parts described above with tin or other suitable wetting agent. In one embodiment, the solder is gold, improving the radiopacity (radiopacity) of the connecting portion, so that the connecting portion is located on the proximal side. Used to act as a line opacity marker. In addition to using gold, the whole or a part of the coil structure 680 can be made of a radiopaque material, thereby further improving the radiopacity of the connecting portion. . In some other embodiments, instead of using a single coil 680, two or more coils 680 that are in contact with each other, such as, for example, a distal closely wound coil, Can be used with a proximal loosely wound coil having a gap located proximally with respect to the distal closely wound coil.

  60A and 60B illustrate several ways in which each distal end segment of wire 661-663 can be attached to distal antenna 676. FIG. In the embodiment shown in FIG. 60A, the distal ends of each of the wires 661-663 are directly bonded to the distal antenna 676 using a bonding agent such as solder or glue. FIG. 60B shows another embodiment, in which each distal end of the wires 661-663 is between the distal antenna 676 and the coil 685 that surrounds the distal antenna 676. FIG. Is intervened. In this type of embodiment, a bonding agent can be introduced inside the coil 685 to bond the coil 685, the distal antenna 676, and the wires 661-663 together.

  Although the foregoing description includes a number of specific details, these specific details should not be construed as limiting the scope of the disclosure herein, and are merely some desirable for the disclosure herein. Should be construed as illustrative of the embodiment. For example, dimension values other than the dimension values listed in this specification are also applicable to this embodiment. For example, an embolus recovery device having an expanded diameter between 1.0 mm and 100.0 mm and a maximum length in the range of 5.0 cm to 10.0 cm This is an application target of this embodiment. It is further understood that most of the features disclosed herein can be interchanged between the various embodiments described above. Those skilled in the art will envision many other potential variations that are within the scope and spirit of the present disclosure. Further, to deliver a vascular treatment device according to embodiments disclosed herein, the device is a catheter, sheath or other instrument with the self-expanding member in a contracted state. It should also be understood that anything that can be delivered to the treatment site and whose self-expanding member can subsequently be deployed at the treatment site within the vessel can be used. The treatment site within the vessel may be (1) for the purpose of diverting the direction of blood flow and / or for the purpose of placing a coil or other similar structure within the aneurysm sac. The possibility of being a certain neck, (2) the possibility of being a site where the embolus exists for the purpose of removing the embolus, and (3) the constriction to increase the speed of blood flow through the vessel For the purpose of expanding the diameter, there is a possibility that the narrowed portion is a site.

Claims (20)

An embolus recovery device for recovering an embolus,
Including a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the cylindrical main body include a proximal V-shaped structure facing the proximal direction and a distal V-shaped structure facing the distal direction,
The proximal V-shaped structure and the distal V-shaped structure are connected to each other by a pair of diagonal and circumferentially spaced struts that extend diagonally and are spaced apart from each other in the circumferential direction.
The proximal V-shaped structure and the distal V-shaped structure have a first average width dimension;
The pair of diagonal and circumferentially spaced struts is an embolus retrieval device having a second average width dimension that is larger than the first average width dimension . The embolus retrieval device according to claim 1, wherein the diagonally and circumferentially spaced struts are substantially straight . The embolus recovery device according to claim 1, wherein the diagonally and circumferentially spaced struts are curved . 2. The embolus retrieval device according to claim 1, wherein the second average width dimension is in a range from 1.1 times to 2.0 times the first average width dimension. 3. Embolization collection device. 2. The embolus retrieval device according to claim 1, wherein the second average width dimension is in a range from 1.2 times to 1.5 times as large as the first average width dimension. Embolization collection device. An embolus recovery device for recovering an embolus,
Including a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the cylindrical main body include a proximal V-shaped structure facing the proximal direction and a distal V-shaped structure facing the distal direction,
The proximal V-shaped structure and the distal V-shaped structure are connected to each other by a pair of diagonal and circumferentially spaced struts that extend diagonally and are spaced apart from each other in the circumferential direction.
The diagonally and circumferentially spaced struts include a first end segment, a second end segment, and an intermediate segment located between the first end segment and the second end segment;
The first end segment is coupled to the proximal V-shaped structure, while the second end segment is coupled to the distal V-shaped structure;
The proximal V-shaped structure and the distal V-shaped structure have a first average width dimension;
The intermediate segments of the diagonally and circumferentially spaced struts have a second average width dimension that is greater than the first average width dimension;
The first end segment and the second end segment of the diagonally and circumferentially spaced struts have a third average width dimension that is larger than the first average width dimension but smaller than the second average width dimension. Collection device. 7. The embolus recovery device according to claim 6, wherein the first end segment and the second end segment of the diagonally and circumferentially spaced struts are tapered . 7. The embolus retrieval device according to claim 6, wherein the diagonally and circumferentially spaced struts are substantially straight . 7. The embolus recovery device according to claim 6, wherein the diagonally and circumferentially spaced struts are curved . 7. The embolus retrieval device according to claim 6, wherein the second average width dimension is in a range from 1.1 times to 2.0 times as large as the first average width dimension. Embolization collection device. 7. The embolus retrieval device according to claim 6, wherein the second average width dimension is in a range from 1.2 times to 1.5 times the first average width dimension. Embolization collection device. An embolus recovery device for recovering an embolus,
Including a longitudinal self-expanding member;
The self-expanding member has a radially expanded state that is radially expanded and a radially unexpanded state that is not radially expanded;
Each of the self-expanding members includes a plurality of wavy elements extending generally in the major axis direction, and a plurality of cell structures in which the wavy elements adjacent to each other are diagonally arranged so as to be diagonally aligned with each other. Have connected to each other to form,
The self-expanding member has a proximal antenna, a proximal end, and a cylindrical body.
The cylindrical body has a proximal section and a distal section;
Among the plurality of cell structures, the one existing in the cylindrical main body extends around the long axis of the self-expanding member over the entire circumference, while the plurality of cell structures are within the proximal end portion. What is present extends partly around the long axis of the self-expanding member rather than over the entire circumference;
Among the plurality of cell structures, those present in the cylindrical main body include a proximal V-shaped structure and a distal V-shaped structure,
The proximal V-shaped structure and the distal V-shaped structure are connected to each other by a pair of diagonal and circumferentially spaced struts that extend diagonally and are spaced apart from each other in the circumferential direction.
At least some of the diagonally and circumferentially spaced struts have one or more wires or ribbons wound therearound when the self-expanding member is in the radially expanded state. An embolus collection device for increasing the average deflection rigidity, which is the rigidity against deflection, of all or a part of a cylindrical main body . 13. The embolic recovery device according to claim 12, wherein the one or more wires or ribbons include a material that is radiopaque . 13. The embolus recovery device according to claim 12, wherein the one or more wires or ribbons include a metal material . 13. The embolic recovery device according to claim 12, wherein the one or more wires or ribbons comprise a polymeric material . 13. The embolus recovery device according to claim 12, wherein the cylindrical main body portion has a first average deflection rigidity when the one or more wires or ribbons are not present, Having a second average deflection stiffness when there are multiple wires or ribbons;
The dimensions and material properties of the one or more wires or ribbons and the number of turns of the one or more wires or ribbons measured per unit length of the diagonally and circumferentially spaced struts The embolus retrieval device is selected such that the second average deflection stiffness is greater than the first average deflection stiffness in a range from about 1.2 times to about 1.8 times . 13. The embolus retrieval device according to claim 12, wherein at least a portion of the plurality of diagonally and circumferentially spaced struts includes one or more winding guide features for guiding the winding. Collection device. 18. The embolus retrieval device according to claim 17, wherein the one or more winding guide features include a plurality of recesses that can accommodate only a portion of the one or more wires or ribbons. device. 13. The embolus retrieval device according to claim 12, further comprising a first flexible wire having a longitudinal shape extending in the proximal direction and connected to the proximal antenna . 21. The embolus retrieval device according to claim 19, wherein one end of the one or more wires or ribbons is at a position where the first flexible wire is coupled to the proximal antenna and to the proximal antenna. Connected embolus recovery device.